Dr. Bethany Kwan

A team of investigators from the University of Colorado School of Medicine Adult & Child Consortium for Health Outcomes Research & Delivery Science (ACCORDS), Jefferson Center for Mental Health, Denver Health & Hospital Authority and Case Western Reserve University/University Hospitals of Cleveland has been approved for a $4.76 million award by the Patient-Centered Outcomes Research Institute (PCORI) to study diabetes shared medical appointments, also called group visits.

A trial in twenty primary care and community mental health centers throughout Colorado, this study will compare the effectiveness of two models of shared medical appointments for people with Type II Diabetes. Diabetes is a highly prevalent chronic disease requiring daily self-care, managing distress and navigating the health care system.

Testing an intervention

Dr. Bethany Kwan, Principal Investigator and Assistant Professor in the Department of Family Medicine, said, “This award is the product of the hard work and dedication of many people. We are delighted to have the opportunity to test research questions that matter to people with diabetes and their family members. It is our hope that this study will inform key principles for diabetes group visits that patients want to attend and that

improve health.”

Dr. Jeanette Waxmonsky

Dr. Jeanette Waxmonsky, Co-Principal Investigator, Director of Research Innovation at Jefferson Center for Mental Health and an Associate Clinical Professor in the Department of Family Medicine, said, “We are excited that we are testing this intervention across a variety of integrated primary and mental health care clinics.”

This project emerged from a multi-year effort to engage multiple stakeholders – patients, caregivers, clinicians and staff from integrated behavioral health and primary care clinics – and researchers in improving diabetes care using a stakeholder engagement process developed at the University of Colorado Anschutz Medical Campus called Boot Camp Translation.

Stakeholders endorsed a model of shared medical appointments involving multidisciplinary care teams, including diabetes peer mentors and a curriculum with physical and mental health education and skills building content. Cohorts of patients could select preferred topics – a patient-driven model. This model will be compared to a model with the same curriculum delivered by health educators only. Patients do not select topics – a standardized model.

‘Research in real-world settings’

Dr. Allison Kempe, Professor of Pediatrics and Director of ACCORDS, said, “This project is a wonderful example of how research in real-world settings can provide important answers that will directly impact the quality of patient care.”

Dr. Don Bechtold, Vice President of Healthcare and Integration, and Medical Director of Jefferson Center for Mental Health, said, “Using the highly prevalent condition of Type II diabetes, this study has the potential to demonstrate the value of integration of mental and physical health and peer support that may also generalize to other disease states and conditions.”

PCORI Executive Director Joe Selby, MD, MPH, said, “This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other stakeholders, but also for its potential to fill an important gap in our health knowledge and give people information to help them weigh the effectiveness of their care options. We look forward to following the study’s progress and working with Drs. Kwan and Waxmonsky to share the results.”

The study was selected for PCORI funding through a highly competitive review process in which patients, clinicians and other stakeholders joined clinical scientists to evaluate the proposals. Applications were assessed for scientific merit, how well they will engage patients and other stakeholders and their methodological rigor among other criteria.

The award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.