Impact on diabetes outcomes and team skills of integrating dietetic services into interprofessional education and teamwork in primary care.
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OBJECTIVES: Diabetes is a complex disease requiring daily self-management of diet and activity, yet many patients do not receive recommended self-management education, medical nutrition therapy, or team-based care that includes registered dietitian nutritionists (RDNs). Such service deficits contribute to challenges in meeting combined diabetes care goals. We evaluated the impact of adding RDN-supervised dietetic interns to an established primary care interprofessional education/teamwork model on patients' clinical outcomes and health professions students' team skills. METHODS: Electronic health records were retrospectively analyzed to evaluate the impact of interprofessional care teams including dietetic practitioners on patient outcomes and compare these changes to outcomes achieved with the previous model without such participation. Pre-test/post-test surveys were used to evaluate health professions students' self-reported changes in team skills. RESULTS: Patient outcomes for glycemic control, systolic blood pressure, triglycerides, and depression improved significantly, and emergency department visits decreased by 79% after interprofessional care. Average hemoglobin A1c levels decreased from 11.6% to 8.3% (p<.001), an additional 1.1% reduction over previous results, following incorporation of dietetic practitioners. Students reported increased team skills after interprofessional care participation. DISCUSSION: Health professions and dietetic program faculty should collaborate to develop interprofessional best practice primary care models for patients with diabetes.
