Date on Paper

8-2019

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Whitney Nash

Committee Member

Beverly Williams-Coleman

Author's Keywords

Adults, prediabetes, lifestyle modifications, diabetes prevention program.

Abstract

Prediabetes does not have to lead to type 2 diabetes. Lifestyle management programs (LMPs) have been shown to reduce the risk of conversion to type 2 diabetes (Diabetes Prevention Research Group (DPRG), 2002), however, research suggests providers refer to LMPs less than 10% of the time (Shiffman et al., 2009). The purpose of this project was to improve prediabetes management by increasing primary care (PCP) referrals to a local Diabetes Prevention Program (DPP) through the use of an educational intervention to increase knowledge of DPP, prediabetes documentation, and steps for DPP referral. The ACE Star Model of Knowledge Transformation guided project design from discovery of knowledge to integration in clinical practice. Outcome measures included number of DPP referrals and prediabetes ICD 10 codes pre and post-education of PCPs and survey responses on barriers to referral. The Wilcoxon Signed Rank test determined statistical significance in change pre and post educational intervention. DPP referrals increased from zero to four post intervention (p=.157) and ICD-10 codes increased from 41 to 43 in the post intervention group (P=.655). The post intervention survey found cost and lack of insurance coverage to be the most common referral barriers. While there were increases in post intervention referrals and ICD10 codes, the results were not statistically significant. This increase, however, warrants further investigation by means of a larger study. Over 50% of patients met criteria for Medicare (45/84). If certification was sought to become a Medicare DPP provider, DPP could be offered at no cost, alleviating referral barriers.

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