“Sustaining Diabetes Shared Medical Appointments After a Pragmatic Trial.”
JABFM
January 2026
Andrea Nederveld, MD, MPH (corresponding author), along with co-authors Russell Glasgow, PhD, and Jodi Summers Holtrop, PhD, MCHES—faculty in the University of Colorado Anschutz Department of Family Medicine—published the research article “Sustaining Diabetes Shared Medical Appointments After a Pragmatic Trial” in the Journal of The American Board of Family Medicine (JABFM).
The article emphasized the benefits of diabetes Shared Medical Appointments (SMAs) in primary care settings, which offer diabetes self-management education and support (DSMES). While SMAs are valued by both patients and providers, sustaining them beyond initial implementation is challenging due to practical and financial barriers. Policy and payment reforms are essential to ensure their long-term viability.
From the article:
“Often, interventions that are effective during trials or initial implementation do not achieve sustainment (the actual continuation of a program or service). Systematic reviews indicate that up to half of all interventions are not sustained past a few years and many are significantly modified or adapted to better fit practice context. Thus, although an intervention may be effective, if it is not continued long-term, the ability to meaningfully impact one’s practice panel and public health is limited. The literature shows that factors that support successful implementation and sustainment include practice champions, leadership support, training, and financial sustainability. It is well established that diabetes SMAs experience sustainability challenges in primary care, including lack of leadership support, staffing turnover or challenges, and concern that reimbursement for the intervention will not cover the cost of implementation and delivery. Recommendations have been made to proactively address these challenges through training, including one-on-one clinical visits in the structure for reimbursement, to enhance sustainability.”
Read more of this article in the JABFM.