Implementing an Exercise Evidence-Based Guideline for Type 2 Diabetes Mellitus Patients Using a Structured Referral Process

Abstract

Introduction: Type 2 Diabetes Mellitus (T2DM) is the seventh leading cause of death in the United States and affects 25.8 million Americans. Ninety to ninety-five percent of T2DM is manifested in adults and prevalence increases with age. Type 2 Diabetes Mellitus is a costly chronic disease that causes dysfunction in multiple organs. The incidence rate of T2DM continues to increase despite numerous efforts of by healthcare providers and politicians to halt this epidemic. New emerging research has shown that exercise in older adults is more effective in delaying and preventing negative healthcare outcomes than medications. Recently multiple healthcare associations have brought forth new Evidence-Base Guidelines (EBGs) on exercise for patients with T2DM: healthcare providers have been slow to respond to these current EBGs. The purpose of this project was to embed an EBG prescription for exercise and design a structured exercise referral process that incorporated a healthcare and community delivery system for patients with T2DM. Methods: The one-group pretest-posttest study design examined the healthcare providers’ knowledge, attitudes, and practices of EBGs before and after the implementation of the structured exercise referral process for patients with T2DM. Results: In this project, an increase in patient referrals was associated with the project’s intervention. In addition, 39% of patients who were referred attended structured exercise class and tended to remain involved in ongoing weekly sessions. Conclusions: Embedding EBGs into the daily clinical process with specific protocols, forms, and staff accountability can increase the likelihood of their use. Further investigation of the impact of structured exercise in older adults on diabetes control is recommended.