Abigail Harrison, DO

INTRODUCTION:
More than 66 million patients are due annually for their Annual Wellness Visit (AWV), which includes discussions on advanced care planning (ACP). For many, this is the only opportunity to address these critical topics. Yet, many patients lack ACP. This study aims to quantify the population without ACP, identify barriers, and increase ACP documentation rates.

METHODS:
This observational, cross-sectional study at the Family Medicine Center (Columbia, SC) ran from July 2024 - February 2025, targeting 300 Medicare patients aged 65+ with active MyChart accounts. Patients without ACP documentation received standardized MyChart messages outlining AWVs and ACP. Afterwards, data was collected on the number of patients with ACP after receiving this message. T-tests and chi-square analysis were used to compare demographic data.

RESULTS:
A random sample of 300 patients included 185 females (61%) and 115 males (38%). In women, 46 had some form of ACP and were excluded. Similarly, 26 men were excluded. In women, 76 (51.7%) did not read the message despite having an active MyChart account, in men 51 (57.3%). Age did not predict message viewing in women (p = 0.929) or men (p = 0.576). Race did not significantly affect message viewing in women (p=0.110). White men were significantly more likely to view the message than African American men (p= 0.00028). African American men had significantly lower message viewing rates than African American women (p=0.00038). There were no patients with new ACP after receiving a MyChart message.

DISCUSSION:
Although no new ACP documentation was uploaded to patients’ charts by the end of the study, over half of the study population did not read the message. This may indicate patients are less likely to read provider messages than previously considered. African American men were the least likely to view the message, suggesting a need for targeted outreach strategies.

Lewandoski Bryson II, MD

Introduction:
Approximately 11.3% of the U.S. population has diabetes. Continuous glucose monitoring (CGM) systems help manage diabetes by providing more efficient and less demanding monitoring. CGMs offer real-time tissue glucose levels, enabling the creation of individualized treatment plans. However, evidence on the effectiveness of interprofessional experiences in educating family medicine residents on the use and interpretation of CGMs is limited. In February 2022, an interdisciplinary CGM clinic was launched at a family medicine clinic (FMC), led by pharmacists and incorporating family medicine residents and medical students. This study aims to assess the clinical, educational, and financial impact of this CGM service on both patients and learners.

Methods:
This is a single-center, retrospective cohort study. Participants included CGM clinic patients seen between February 2022 and December 2024, as well as the clinic’s residents. Patients were excluded if they did not attend the CGM interpretation visit. Statistical analysis included descriptive statistics, chi-squared, and Fisher’s exact tests for continuous and categorical data as appropriate.

Results:
In the first two rounds of data collection, the average A1c reduction was similar between the two groups at 1.3% and 1.4%, respectively. There was a statistically significant increase in diabetes preventative screenings compared to baseline.

Discussion:
Following participation in the interdisciplinary CGM clinic, patients experienced an average A1c reduction of 1.4%, which is comparable to reductions seen with metformin monotherapy or GLP-1 agonists. The consistency of A1c improvement across collection periods indicates reliability of the intervention. Preventative screenings also increased significantly, demonstrating a broader impact of the clinic. This is particularly meaningful given the high prevalence of diabetes and associated complications in the clinic’s local zip code compared to national averages.

Monyetta Hanson, DO and Cassandra Greene, DO

Introduction: Obesity, defined as a BMI greater than 30 kg/m², carries an economic burden of $173 billion annually. South Carolina has one of the highest obesity rates in the country at 36.1%. This project aimed to implement obesity group visits at the Family Medicine Center (FMC) to improve health by reducing BMI and enhancing quality of life.

Methods: This was a prospective pilot project approved by the Prisma Health IRB. Eligible participants were adults (18–65 years) from FMC with a BMI of 30 kg/m² or greater and an obesity-related comorbidity. Group visits, led by family medicine residents, were held biweekly for 3 months and focused on the six pillars of lifestyle medicine: physical activity, stress management, social connection, avoiding risky substances, nutrition, and restorative sleep. Sessions included exercise, education, group discussions, and mindfulness exercises. Weight and blood pressure were measured at each visit, and surveys on healthy habits and perception of quality of life were administered at the first and last sessions.

Results: Five participants enrolled in the program, with two successfully completing it. One participant showed a 1.91% increase in weight, while the other showed a 1.36% increase. One participant reported a 33% improvement in quality of life. Additionally, this participant reported improved healthy lifestyle habits and increased confidence in making healthy changes. All participants had a reduction in blood pressure. Both were prescribed GLP-1 medications following recent Medicaid requirement changes.

Discussion: Although the study was limited by a small sample size, the positive outcomes suggest that group visits, combined with education, can encourage healthier behaviors. This project helped to lay the foundation for future cohorts of obesity group visits by demonstrating its feasibility. With recent South Carolina Medicaid updates allowing GLP-1 prescriptions after multiple nutritional counseling visits, this project may enhance access, patient buy-in, and long-term health outcomes.

Shant Thomassian, MD; Caleb Wahdan; Morgan Adams Rhodes, PharmD

Introduction:
Hypertension and diabetes are among the most common chronic diseases managed in primary care, yet significant disparities exist in patient outcomes based on insurance status. Uninsured and underinsured individuals often experience barriers to healthcare access, resulting in delayed diagnosis, poor disease control, and higher rates of complications. Variability in insurance coverage, including differences in formularies, provider networks, and out-of-pocket costs, may also impact adherence to treatment. This study investigates the relationship between insurance coverage and health outcomes in patients with hypertension and diabetes at a South Carolina community health center serving a predominantly uninsured and underinsured population.

Methods:
This prospective observational cohort study is enrolling 100 adult patients with hypertension and/or diabetes. Data collection includes retrospective chart reviews, patient surveys, and follow-up assessments over 12 months. Primary outcomes include blood pressure control, glycemic control measured by hemoglobin A1c levels, emergency department visits, hospitalizations, and the incidence of hypertension- and diabetes-related complications. Additional analyses will assess the influence of socioeconomic factors such as income, education, and transportation access on healthcare utilization and disease management.

Results:
Data collection is ongoing. This study will evaluate trends in disease management based on insurance coverage, assessing differences in clinical outcomes and healthcare utilization. Hypotheses suggest that patients with limited or no insurance will have poorer blood pressure and glycemic control, higher emergency department utilization, and increased rates of complications. Variations in insurance plans may also contribute to disparities in medication adherence and access to preventive care.

Discussion:
Findings from this study may support funding for larger multi-facility investigations to further explore the relationship between insurance status and chronic disease outcomes. These results may ultimately inform policy recommendations and clinical interventions aimed at improving healthcare accessibility, affordability, and continuity of care for vulnerable populations.

James Harley, DO

Introduction:
Media is a ubiquitous part of everyday life. There are many good and bad sources of information found through internet searches and social media platforms, particularly related to healthcare. Clinicians can create evidence-based media that provides accurate health information to patients, with specific attention to those with low health literacy.

Methods:
The project involved producing a series of one-minute videos addressing common topics in diabetes management. These videos were then presented to patients to assess their usefulness. Data was collected using a flyer with QR codes for the videos, distributed to patients with diabetes, with the assistance of the diabetic teaching coordinator in our office. Videos were also sent via electronic medical record (EMR) messaging to the diabetic registry with links to the videos.

Results:
A total of six videos were produced. There were 13 responses to the patient survey. The more effective method of delivery was through the EMR using the registry. Overall, 75% of respondents provided positive feedback about the videos. Feedback included appreciation for the videos being brief, educational, and somewhat humorous. Criticisms included notification fatigue and a lack of in-depth information, which made the content less beneficial for patients with longstanding disease.

Conclusions:
Short-format videos educating patients on common disease topics were generally well received and can be beneficial, especially for newly diagnosed patients or those with low healthcare literacy. Considerations must be made regarding the time required to produce the videos, which can be significant. The best topics may be those that are commonly asked about, and having a ready-made, reliable, and accurate resource to direct patients to may help reinforce teaching done during clinic visits.