Shared Medical Appointments for Patients Living With Diabetes: Transforming Care in Rural Chiapas, Mexico

Abstract

The number of people living with diabetes worldwide is growing at alarming rates, causing widespread morbidity, mortality and increasing healthcare costs. Low-and-middle-income countries (LMIC) bear most of the disease burden and have fewer opportunities to develop and implement new strategies to help LMIC cope with the demand and provide quality healthcare to patients. Shared Medical Appointments (SMA) are a patient-centered strategy that can be implemented by healthcare providers in low-resource settings to foster patient engagement and comprehensive care delivery. We conducted a qualitative assessment of an SMA intervention taking place in 5 clinics in rural Chiapas, Mexico. Fifty in-depth interviews with patients and providers, along with five focus group discussions with community health workers, provided valuable insights to the processes taking place when engaging in SMA that lead to a transformation of care. The implementation of an SMA model in this setting brought about numerous changes in the way diabetes care is perceived, structured, and delivered. The model also restructured some operational aspects in the clinics, such as patient flow. By bringing more providers to the table, SMAs foster the sharing of power and responsibilities amongst the staff involved in the sessions. SMAs are a non-traditional approach to care delivery that transforms care to better suit the needs of the patients and reshape providers’ roles to create a new standard of health delivery that benefits everyone involved.