Shared medical appointments: an adjunct for chronic disease management in Australia?

Background: The incidence of chronic disease continues largely unabated in modern western societies. While the content (physiology, determinants) of these diseases is well studied, processes of dealing with them at the clinical level have been less well considered. Shared medical appointments (SMAs) or group consultations (also often referred to as group visits) are ‘a series of individual office visits sequentially attending to each patient’s unique medical needs individually, but in a supportive group setting where all can listen, interact and learn’. Objective: To examine the potential acceptability of SMAs for the management of chronic diseases in the Australian context. Discussion: SMAs were developed in the US to improve access to care, utilise peer support, reduce costs and improve patient and provider satisfaction in the management of chronic disease. An SMA is a comprehensive medical visit, not just a group education session, where a significant part of the added value comes from the facilitated peer interaction, particularly around aspects of self-management and empowerment. While more studies are required to compare outcomes with conventional one-on-one consultations, the reported gains in time efficiency, patient numbers managed, and patient as well as provider satisfaction, are sufficient to justify further consideration of a trial of SMAs in Australia.