Understanding Patient Motivation and Barriers to Self-Management of Type 2 Diabetes Anisha Patel MSIII, Christine Payne MD, Martha Seagrave PA-C University of Vermont College of Medicine IntroductionConclusions References Results Objectives Methods Vermont Behavioral Risk Factor Surveillance System. Rep. Vermont Department of Health, September Web Stellefson M, Dipnarine K, Stopka C. The chronic care model and diabetes management in US primary care settings: a systematic review. Prev Chronic Dis. 2013;10:E Wagner EH, Davis C, Schaefer J, Vonkorff M, Austin B. A survey of leading chronic disease management programs: are they consistent with the literature?. Manag Care Q. 1999;7(3): J. Photo credits: Rajan Chawla Understand patient perspective on self- management support. Understand challenges of living with diabetes. Improve self-management support by promoting strategies most utilized by patients. Designed a survey to assess patient perspective on: o ‘My Health Diary’: a folder including patient goals, lab results, logs for daily blood sugars, and upcoming appointments o Meetings with a Certified Diabetes Educator (CDE) o Follow-up phone monitoring Interviewed 20 patients with a documented diagnosis of Type 2 Diabetes Presented results at the Patient Centered Medical Home meeting of Waterbury Medical Associates. Type 2 Diabetes is a major cause of cardiovascular disease in the United States. In Vermont, diabetes affects 7% of the adult population 1. This project focuses on patient experiences with self-management support, one of six components of the Chronic Care Model shown to improve diabetes outcomes nationwide 2. In conjunction with Waterbury Medical Associates, a primary care clinic in rural Vermont, we assessed patient perspectives on self-management of diabetes and barriers to making lifestyle changes required of diabetes. Maximize use of self-management tools already implemented in the clinic: o “My Health Diary” for all diabetes patients. o Annual meetings with the CDE o Follow-up phone monitoring at regular weekly or bimonthly intervals. Implement other components of Chronic Care Model to optimize care: o Delivery system design: organize “Diabetes Days” to coordinate office visits with PCPs and CDEs 1. o Health system— organization of health care: evaluate clinical outcomes of patients treated using the Chronic Care Model. Patient responses to living with Type 2 Diabetes: “I bet I could eat nothing all day and my sugar would be high” “I just don’t eat when I’m hungry” “I don’t have time to exercise” “Not being able to eat what I want” “My grandchildren are my motivation” Recommendations Most patients consider self-management support to be helpful in managing diabetes. “My Health Diary” and CDE meetings are the most utilized strategies. Most patients do not recall receiving a phone call due to the irregular nature of monitoring. Patients have many misconceptions about healthy diabetes diets. Most patients do not incorporate exercise into diabetes management. Patient responses to self- management tools: Project Sponsored by HRSA Grant Award D56HP