Improving Referrals to a Diabetes Self-Management Education Program in a Primary Care Clinic

Despite the proven benefits and recommendations from the American Diabetes Association (ADA) to refer patients with type 2 diabetes to a diabetes self-management education (DSME) program, the referral rates to such programs by primary care providers (PCP) is considerably low. Only 6.8% of individuals with newly diagnosed type 2 diabetes with private health insurance have participated in DSME within 12 months of diagnosis, and only 4% of Medicare participants received DSME (Powers et al., 2020). The goal of this quality improvement project was to improve management of diabetes in primary care practice through increased awareness and engagement in DSME programs. The project was implemented at a metropolitan clinic in South Florida and included two PCP and their patients with a type 2 diabetes diagnosis. During an implementation phase, an educational session was given to each PCP with an intent to increase awareness on DSME, demonstrate its importance and recommendations by the ADA on its use, as well as educate on how and when to refer a patient with diabetes to a DSME program. Data were analyzed using descriptive statistics (percentages), and dependent sample t-test analyses. This quality improvement project resulted in improved post intervention DSME Questionnaire PCP scores, increased rates of referrals, increased rates of attendance to a DSME program and decreased HbA1c levels. These results demonstrate that an instructional intervention can positively influence PCP knowledge and standardized use of current evidence-based practice guidelines for treating adults with type 2 diabetes in a primary care setting.