665-P: Diabetes Self-Management Education (DSME): What Will It Take to Improve Participation?

Despite evidence that DSME is a critical component of diabetes (DM) care, participation remains low. Innovative methods to improve attendance need to be explored. The purpose of this study was to evaluate the impact of a primary care (PC)-based DSME delivery model on DSME referrals and participation. Using a non-randomized design, diabetes educators (DEs) and PC practices were assigned to the intervention group (IG; 3 DEs, 6 practices) or control (CG; 2 DEs, 6 practices). IG practices applied patient-centered medical home elements to DSME delivery and had direct access to a DE. The CG employed traditional DSME delivery (PC patients referred to hospital-based DE). To examine DSME referrals and participation, medical record data were extracted for patients with DM, 18-75y, presenting to PC practices over 18 months (n=4,894; 59% IG, mean age 58.7y, 50.8% male) and compared between study groups. IG practices referred a higher percentage of patients to DSME compared to CG (18.4% v 13.4%; p