Document Detail


The Chronic Care Model and Exercise Discussions during Primary Care Diabetes Encounters.
MedLine Citation:
PMID:  21209341     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: discussing self-care activities like exercise is challenging with the many competing demands during primary care encounters. Our objective was to study the relationship between the Chronic Care Model (CCM) score in the clinic and time spent by the physicians discussing exercise during encounters with diabetic patients.
METHODS: consecutive patients with diabetes across 20 primary care clinics in South Texas were included. Time spent discussing exercise was determined using the Davis Observation Code on audio recordings of the visits. Clinicians completed the Assessment of Chronic Illness Care survey, a validated measure of the extent to which care delivered is consistent with the CCM. Data were analyzed using hierarchical linear models.
RESULTS: a total of 162 transcribed recordings were analyzed. Age, the number of problems addressed, stage of change (SOC), and overall length of the visit were associated with time spent discussing exercise. There was a significant relationship between clinic CCM score and time spent by physicians advising about exercise, independent of SOC for exercise (P < .01). Also, a discussion about exercise was more likely to occur with patients who were in the contemplation SOC for exercise.
CONCLUSIONS: discussions of exercise may be 18 to 33 seconds longer in clinics with full implementation of the CCM compared with those with basic implementation. Facilitating more complete CCM implementation in clinics with a basic level of CCM that serve a population of patients who are sedentary may realize the most benefit.
Authors:
Neela K Patel; Michael L Parchman
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Board of Family Medicine : JABFM     Volume:  24     ISSN:  1557-2625     ISO Abbreviation:  J Am Board Fam Med     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2011-01-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101256526     Medline TA:  J Am Board Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  26-32     Citation Subset:  IM    
Affiliation:
Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, TX 78229-3900, USA. Pateln4@uthscsa.edu
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MeSH Terms
Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
D01 HP08795//PHS HHS; K08 HS013008-03/HS/AHRQ HHS

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