Ruggiero and colleagues evaluated the impact of an intervention that utilized a certified medical assistant with specific diabetes training to work with a multidisciplinary diabetes care team to help provide basic diabetes education and self-care support in low-income minority populations with type 2 diabetes. Enrolled participants were randomized to either the medical assistant coaching (MAC) group (N = 25) or the treatment as usual (TAU) group (N = 25). Nonidentified data was obtained on a matched no contact control (NCC) group (N = 50). Analysis of covariance (ANCOVA) comparisons revealed no significant differences between the 3 groups on A1C, but a trend was observed. A1Cs decreased across time for the MAC group, while increasing for the TAU and NCC groups. ANCOVA comparisons also indicated that the MAC group experienced significantly greater increases in perceived empowerment and a larger, although nonsignificant, reduction in perceived diabetes related problems than the TAU group.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that this randomized controlled pilot study suggests that the inclusion of a medical assistant self-care coach as part of the diabetes care team holds promise in improving outcomes. It should be further examined in a large-scale study.

WHAT THE STUDY MAY MEAN TO YOU S A PATIENT: This is another approach to teaching self-management skills to patients with diabetes. Perhaps a more significant role of these medical assistants would be to interview and assess patients as to their performance of the skills once or twice a year following training. This could insure that patients continue to use self-management as long as needed.

L Ruggiero et al. Supporting diabetes self-care in underserved populations: a randomized pilot study using medical assistant coaches. Diabetes Education, 2010;36:127-131.