Abstract
The Diabetes Education Study was a controlled trial of the effects of physician and patient education. This article describes an educational program for internal medicine residents and its effects on ambulatory diabetes management practices. Forty-five of 86 residents practicing in the general medicine clinic of a university-affiliated city/county hospital were assigned randomly to receive a multifaceted program intended to 1) provide specific care recommendations, 2) teach necessary skills, and 3) make the professional and institutional environment more supportive. During the subsequent 11 months, 323 diabetic patients were interviewed and their records audited for evidence of changes in care. Experimental residents utilized fasting blood glucose determinations more often than controls (i.e., during 40% of visits vs. 31%, p=0.004). Experimental residents also engaged more frequently in a variety of recommended dietary management recommendations. Isolated differences in monitoring/management of chronic complications also were found (e.g., lipid screening: 70% of experimental residents’ patients vs. 58%, p=0.016). Intensive, multifaceted programs of this nature are concluded to result in improvements in diabetes care, over and above that which is attainable through routine methods of clinical training for residents.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Mazze R, Deeb L, Palumbo PJ. Altering physicians’ practice patterns—a nationwide educational experiment: evaluation of the dinical education program of the American Diabetes Association. Diabetes Care 1986;9:420–5
Sanazaro PJ. Determining physicians’ performance: continuing medical education and other interacting variables. Evaluation and the Health Professions 1983;6:197–210
Manning PR. Continuing medical education: the next step. JAMA 1983,249:1042–5
Eisenberg JM, Williams SV. Cost containment and changing physicans’ practice behavior: can the fox learn to guard the chicken coop? JAMA 1981;246:2195–2201
Ashbaugh DG, McKean RS. Continuing medical education: the philosophy and use of audit. JAMA 1976;236:1485–8
Sanazaro PJ, Worth RM. Concurrent quality assurance in hospital care—report of a study by Private Initiative in PSRO. N Engl J Med 1978;298:1171–7
Pinkerton RE, Tinanoff N, Willms JL, Topp JT. Resident physician performance in a continuing education format—does newly acquired knowledge improve patient care? JAMA 1980;244:2183–5
Inui TS, Yourtee EL, Williamson JW. Improved outcomes in hypertension after physician tutorials—a controlled trial. Ann Intern Med 1976,84:646–51
Laxdal OE, Jennett PA, Wilson TW, Salisbury GM. Improving physician performance by continuing medical education. Can Med Assoc J 1978;118:1051–8
Linn BS. Continuing medical education—impact on emergency room burn care. JAMA 1980;244:565–70
McDonald CJ: Protocol-based computer reminders, the quality of care and the non-perfectability of man. N Engl J Med 1976;295:1351–5
Mazzuca SA, Moorman NH, Wheeler ML, et al. The Diabetes Education Study: a controlled trial of the effects of diabetes patient education. Diabetes Care 1986;9:1–10
Vinicor F, Cohen SJ, Mazzuca SA, et al. DIABEDS: a randomized trial of the effects of physician and/or patient education on diabetes patient outcomes. J Chronic Dis 1987;40:345–56
Clark CM Jr. Problem-oriented protocols: a physician’s pocket guide to care for ambulatory diabetes mellitus. In: Mazze RS (ed): Professional Education in Diabetes. Bethesda, MD: National Diabetes Information Clearinghouse; 1983:111–36
McDonald CJ, Murray R, Jeris D, Bhargava B, Seeger J, Blevens L. A computer-based record and clinical monitoring system for ambulatory care. Am J Public Health 1977;67:240–5
McDonald CJ. Use of a computer to detect and respond to clinical events: its effect on clinician behavior. Ann Intern Med 1976;84:162–7
Cohen SJ, Mazzuca SA. The role of problem-oriented protocols in the education and evaluation of house staff. In: Mazze RS (ed): Professional Education in Diabetes. Bethesda, MD: National Diabetes Information Clearinghouse; 1983:101–10
American Diabetes Association and American Dietetic Association. A Guide for Professionals: The Effective Application of “Exchange Lists for Meal Planning.” New York: American Diabetes Association, 1977
Mulrow C, Bailey S, Sönksen PH, Slavin B. Evaluation of an audiovisual diabetes education program: negative results of a randomized trial of patients with non-insulin dependent diabetes mellitus. JGIM 1987;2:215–9
Kaplan RM, Hartwell SL, Wilson DK, Wallace JP. Effects of diet and exercise interventions on control and quality of life in non-insulin-dependent diabetes mellitus. JGIM 1987;2:220–7
Author information
Authors and Affiliations
Additional information
Received from the Departments of Medicine and Medical Genetics, Indiana University School of Medicine, and the Regenstrief Institute for Health Care, Indianapolis, Indiana.
Supported by the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases (PHS P60 AM20542).
Rights and permissions
About this article
Cite this article
Mazzuca, S.A., Vinicor, F., Cohen, S.J. et al. The diabetes education study. J Gen Intern Med 3, 1–8 (1988). https://doi.org/10.1007/BF02595748
Issue Date:
DOI: https://doi.org/10.1007/BF02595748