NEW ORLEANS — Better continuity of care results in higher patient satisfaction and better hemoglobin A1c levels in patients with type 2 diabetes, according to a speaker here.

Type 2 diabetes costs exceed $176 billion annually in the United States, and patients with the disease frequently have poor glycemic control, which can result in micro- and macro-vascular complications and end organ damage. 

“I was trying to find ways to improve HbA1c levels in patients with type 2 diabetes without changing medications, but with things that nurse practitioners, physicians and other healthcare providers can implement in their practice templates,” Brad Franklin, RN, DNP, FNP-C, of Blanchfield Army Community Hospital in Fort Campbell, Kentucky, said during a poster session at the American Association of Nurse Practitioners 2015 meeting.

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So he performed a systematic literature review of 11 U.S. and international research studies that looked at how continuity of care influenced HbA1c levels in patients with diabetes.

He then extrapolated the following practice recommendations to achieve better long-term, sustained relationships between patients with type 2 diabetes and health care providers:

Use telemedicine to expand care beyond traditional face-to-face health care encounters 

Incorporate telephone reminders to reduce no-show rates for scheduled appointments

Utilize clinic nurses to make regular contact with patients about educational interventions and to answer patient questions after provider encounters

  • Increase patient access to health records, specifically lab test results specific to type 2 diabetes
  • Routinely monitor patient satisfaction surveys and implement measures to increase satisfaction
  • Implement open scheduling policies
  • Schedule patients with the same provider each visit

“Making some simple process changes to the medical practice that do not require additional costs for the patient can improve HbA1c and positively influence type 2 diabetes outcomes long term,” Franklin said.


  1. Franklin B. Poster Session. “Type 2 Diabetes Mellitus and Continuity of Care: NPs Can Make a Difference.” Presented at: AANP 2015. June 10-14; New Orleans.