Comparative Effectiveness of Goal Setting in Diabetes Mellitus Group Clinics

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Abstract
Diabetes mellitus (DM) is a serious and growing public health problem.1 The prevalence and morbidity of DM are greater among older adults who often have multiple chronic morbidities.2,3 Self-management skills are an essential means of reducing morbidity and health services use among older, comorbid patients with DM.4,5 However, delivery of effective self-management education and support can be difficult in traditional primary care, even among patients who have access to care, medications, and DM educators but who also have persistently uncontrolled DM.6 Many primary care clinics have few personnel trained to effectively deliver self-management education and support for chronic DM care. Furthermore, DM self-management is often poorly integrated with the physician-patient encounter, and evidence-linking self-management activities and health outcomes are often indirect at best.5,7