Parkland program takes AIM at diabetes

Parkland program takes AIM at diabetes

Behavioral health issues put patients at greater risk

“Diabetes is a difficult disease to manage, but for those with behavioral health issues, the challenges of dealing with diabetes and other chronic illnesses are magnified,” said Kellie Rodriguez, MSN, MBA, CDE, Director of Diabetes Education at Parkland Health & Hospital System.

During November, National Diabetes Awareness Month, healthcare providers like Parkland are emphasizing the need for education and outreach programs to help deal with this serious disease. More than 30 million people in the U.S. have been diagnosed with the disease and another 84 million have prediabetes. In Dallas County, 11 percent of the population has diabetes and more than 30,000 patients with the condition currently receive care at Parkland.

National studies show that patients with behavioral health issues die on average 25 years younger than the rest of the population, with the majority of deaths caused by chronic illnesses like diabetes and cardiovascular disease.

Because of this trend, an innovative program at Parkland is focusing on behavioral health patients diagnosed with uncontrolled diabetes. The Acute Integrated Mental Health Services (AIMS) program was initially developed through a gift from The Meadows Foundation to meet the needs of patients with complex behavioral health and with diabetes who are at risk of poor outcomes. Patients referred to the program also faced enormous barriers related to poverty including lack of access to affordable healthy foods, transportation and medications.

“Our provider and social worker in the AIMS program provide home and clinic visits to better understand the barriers facing these patients. Then we connect patients with resources needed to keep them on the path to improved health. In addition, we help patients manage their behavioral and medical health using an integrated treatment approach,” said Minnie Mathew, Department Manager, Outpatient Psychiatric Services at Parkland.

Julie Guerrero-Montoya, 44, of Dallas, said she was in denial after she was diagnosed with diabetes. With assistance from AIMS, her diabetes is now under control, her A1C cut almost in half from 12 percent to 6.3 percent. The AIMS program has also taught her how to eat better, facilitated access to a food pantry and is helping her emotionally.

“I am very grateful because people like me need this program. AIMS helps me a lot with my diabetes and connects me to other resources,” she said. “Otherwise I would not know where to go or where to start.”

The AIMS program helps patients with:
• Intervention and risk assessment
• Wellness, preventive care and education
• Medical history evaluation
• Diagnosis and treatment of diabetic and mental health conditions
• Tracking labs and medication
• Overcoming barriers to care
• Collaboration between primary care providers, diabetic specialist and psychiatrists
• Referrals to primary care, psychiatry and other specialty care
• Counseling and support
• Case management services

First-year results of the program demonstrated a positive impact on patients’ overall health and well-being,” Rodriguez said.

The Hemoglobin A1C levels among the patients decreased from an average of 11.7 percent to 8.7 percent.

“For one patient in the program, it meant her diabetes reached a level enabling her to become a candidate for reconstructive surgery following a double mastectomy years earlier. Program outcomes also included decreases in body mass index, cholesterol, triglycerides, emergency room visits and PHQ-9 scores that measure depression,” said Elizabeth Simmons, LCSW, AIMS social worker.

Thanks to these successful outcomes, Parkland made the AIMS program a permanent part of the behavioral health department this year.
“With the support of programs like AIMS, patients no longer need to rely only on the emergency department for care,” Mathew said. “Many of our patients have so many obstacles to improving their health. I’m proud that we can continue to develop and expand the program to reach even more patients in need of this type of integrated care.”

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