A detailed curriculum will be developed to train nurses in optimal diabetes care. For more information about Penn State Diabetes Center, visit the Web site at …
News Release
Penn State College of Medicine Tel: 717 531-8606
Penn State Milton S Hershey Medical Center Fax: 717 531-
6999
Strategic Services, A140
600 Centerview Drive
PO Box 855
Hershey, PA 17033-0855
FOR IMMEDIATE RELEASE MEDIA INQUIRIES CONTACT:
Monday, Oct 10, 2005 Mike Stevens 717 531-8606
e-mail: mstevens@psuedu
3 MILLION GRANT FUNDS STUDY OF NURSE CASE MANAGEMENT ON IMPACT ON HEALTH
OF PEOPLE WITH DIABETES
HERSHEY, PA- A Penn State Milton S Hershey Medical Center-led team has
been awarded a five-year, 3 million grant from the National Institute of
Diabetes and Digestive and Kidney Diseases of the National Institutes of
Health, to study whether enhanced nursing care in the primary care setting
can reduce sickness and death from complications of Type 2 diabetes
Achieving and maintaining certain goals for blood glucose levels,
blood pressure, cholesterol, exercise and more have already been shown to
reduce or prevent the incidence of complications of diabetes such as heart
disease, kidney failure, blindness and amputations, said Robert A Gabbay,
MD,
PhD, principle investigator for the project, co-director of Penn
State Diabetes Center, and associate professor of medicine, Penn State
College of Medicine, Penn State Hershey Medical Center National surveys
indicate, however, that the majority of patients fall short on these goals
and we believe the reason to stem from challenges with the primary care
system
Some of these challenges include lack of adequate time physicians are
able to spend with patients, patient adherence to recommended testing and
treatment strategies, and some resistance to following nationally-
recognized guidelines set by the American Diabetes Association, American
Heart Association, etc Gabbays study will determine if enhanced nurse
case management can counteract some of these barriers to encourage optimal
diabetes care
In the study, patients from 12 primary care clinics in the Hershey
and Reading, Pa, areas will be randomized into two groups The 12 clinics
include all nine Penn State Hershey-affiliated general internal medicine
and family medicine primary care facilities that are part of the Penn State
Ambulatory Research Network, and three additional clinics in Reading that
provide care to an
underserved Hispanic population For three years, one
group will receive usual care, and the other group of patients will receive
enhanced nursing case management intervention during regular office visits
This will include individualized behavior change counseling using a new
technique called motivational interviewing to encourage patient adherence
to diet and ensure appropriate blood sugar checks, medication dosing and
exercise A detailed curriculum will be developed to train nurses in
optimal diabetes care Nurses will work closely with primary care
physicians to help patients with diabetes achieve the established goals for
care that have already been shown to prevent the potentially devastating
complications of diabetes
One focus of the study is to test the effectiveness of nurse case
management on the Hispanic population, which has a much higher incidence of
diabetes, Gabbay said In fact, 102 percent of Hispanics have diabetes
and, according to statistics, half of all Hispanic girls born in the year
2000 will develop diabetes in their lifetimes In our study, about 38
percent of participants will be Hispanic, providing us with an opportunity
to see how these nurse case
management interventions might improve health
outcomes for this often underserved minority population
Along with monitoring the health of all participants over the three
years, the study will measure cost-effectiveness of the enriched nurse case
management intervention by tracking whether those receiving the
interventions experience fewer hospital admissions, fewer heart attacks,
and fewer emergency room visits The study will also track whether those in
the intervention group have improved quality of life, patient satisfaction
and self-management behaviors
People often are fearful of low blood sugars and developing
complications, and have concerns that theyre not getting adequate help,
feelings of powerlessness, depression and more, Gabbay said We want to
see if these interventions cause improved adherence to self-care
guidelines, higher quality of life and lower levels of diabetes specific
emotional distress We also feel that these interventions may have a
positive impact on provider satisfaction because many physicians too are
frustrated with the current system that gives them little time to provide
the care that they want
Ultimately, Gabbay hopes this study
will give health care providers,
payers, and policymakers a valuable model of how to improve the care of
patients with diabetes in the primary care setting, and give those with
diabetes the tools and encouragement to take good care of themselves
between doctors appointments
The study involves collaboration of a large number of Penn State and
outside collaborators: Alan Adelman, MD, director of the Primary Care
Research Network and professor of family and community medicine; Cheryl
Dellasega, GNP, PhD, professor of medicine; Irina Lendel, MD, Mary
Collins, CDE, Division of Endocrinology, Diabetes and Metabolism; Chris
Hollenbeak, PhD, assistant professor of health evaluation sciences; and
David T Mauger, PhD, associate professor of health evaluation sciences,
Penn State College of Medicine; David Johnson, PhD, Penn State Center for
Survey Research at Penn State University Park; David George, MD, and Tipu
Faiz Saleem, MD, internal medicine, Reading Hospital, Reading, Pa;
Deborah Van Horne, PhD, University of Pennsylvania; Carol Horowitz, MD,
MPH, Mt Sinai School of Medicine; Eric Ford, PhD, Tulane University;
Garry Welch, MD, Baystate Medical Center; and Robert
Weech-Maldonado,
MBA, PhD, University of Florida, Gainesville
For more information about the study, patients may call 717 531-
3592 For more information about Penn State Diabetes Center, visit the Web
site at http://wwwpennstatediabetescentercom
