Shared Visits for Health Care Consumers in a Rural Free Clinic Setting

Abstract

Background: One of every four adults in the United States lives with two or more chronic diseases.  Current care delivery models may not adequately address diabetes or hypertension management challenges. Shared visits may provide more efficient chronic illness care. 

Purpose: The purpose of this advanced practice registered nurse-led study was to conduct a pilot program to test the effectiveness of shared visits for low-income, uninsured, rural health care consumers who have uncontrolled chronic type II diabetes or hypertension and who receive care at a rural free clinic.

Methods:  A convenience sample of two groups of adults with diabetes and one group with hypertension engaged in shared health care visits that included shared education and discussion. Data were analyzed using descriptive and inferential statistics.

Findings: Fifty-three percent of diabetes participants had reduced hemoglobin A1c. A statistically significant difference in systolic blood pressure (p = 0.01) was found for the hypertension group. Seventy-eight percent of participants had lower diastolic pressure.

Conclusion: Shared visits show good potential for better self-management and improved outcomes among rural, low-income, uninsured health care consumers who have uncontrolled chronic type II diabetes or hypertension. 

Keywords: Advanced Practice Registered Nurses; Chronic Disease; Diabetes Mellitus, Type 2; Primary Health Care; Rural Health; Self-care

DOI:  http://dx.doi.org/10.14574/ojrnhc.v18i1.457