OBJECTIVES: To determine whether diabetes disease management (DM) programs are able to improve adherence to glycosylated hemoglobin (A1C) and low-density lipoprotein cholesterol (LDL-C) clinical testing in a nonadherent population and to quantify the efficacy of telephonic interventions in improving clinical testing rates. STUDY DESIGN: Retrospective, observational cohort study before and after DM program implementation. METHODS: A baseline cohort of members with diabetes (n = 5640) was identified from among large-scale diabetes DM programs administered for 13 geographically diverse health plans. Members were defined by nonadherence at baseline to A1C and/or LDL-C testing, grouped together based on how long they had participated in the program, divided retrospectively into telephonically contacted and uncontacted groups, and analyzed in the subsequent 12-month implementation period for testing rates. Subgroups defined by disease burden at baseline and frequency of telephonic interactions were analyzed to determine achievement of guideline-based A1C and LDL-C testing rates. RESULTS: Participation in diabetes DM programs was associated with improved A1C and LDL-C testing rates in previously nonadherent members. Calling nonadherent members improved A1C testing by 30.2% and LDL-C testing by 10.9% compared with testing rates for members who were not called. Members with high disease burden benefited even more from the diabetes intervention. Frequency of telephonic contacts with nonadherent individuals demonstrated a linear relationship with improved rates of adherence to A1C and LDL-C testing guidelines, and markedly improved testing rates compared with a not-called group. CONCLUSION: Telephonic interventions as part of comprehensive DM programs are associated with improved disease-monitoring testing.
OBJECTIVES: To determine whether diabetes disease management (DM) programs are able to improve adherence to glycosylated hemoglobin (A1C) and low-density lipoprotein cholesterol (LDL-C) clinical testing in a nonadherent population and to quantify the efficacy of telephonic interventions in improving clinical testing rates. STUDY DESIGN: Retrospective, observational cohort study before and after DM program implementation. METHODS: A baseline cohort of members with diabetes (n = 5640) was identified from among large-scale diabetes DM programs administered for 13 geographically diverse health plans. Members were defined by nonadherence at baseline to A1C and/or LDL-C testing, grouped together based on how long they had participated in the program, divided retrospectively into telephonically contacted and uncontacted groups, and analyzed in the subsequent 12-month implementation period for testing rates. Subgroups defined by disease burden at baseline and frequency of telephonic interactions were analyzed to determine achievement of guideline-based A1C and LDL-C testing rates. RESULTS: Participation in diabetes DM programs was associated with improved A1C and LDL-C testing rates in previously nonadherent members. Calling nonadherent members improved A1C testing by 30.2% and LDL-C testing by 10.9% compared with testing rates for members who were not called. Members with high disease burden benefited even more from the diabetes intervention. Frequency of telephonic contacts with nonadherent individuals demonstrated a linear relationship with improved rates of adherence to A1C and LDL-C testing guidelines, and markedly improved testing rates compared with a not-called group. CONCLUSION: Telephonic interventions as part of comprehensive DM programs are associated with improved disease-monitoring testing.
Authors: Brent Hamar; Aaron Wells; William Gandy; Andreas Haaf; Carter Coberley; James E Pope; Elizabeth Y Rula Journal: Popul Health Manag Date: 2010-11-23 Impact factor: 2.459
Authors: G Brent Hamar; Elizabeth Y Rula; Aaron Wells; Carter Coberley; James E Pope; Shaun Larkin Journal: Popul Health Manag Date: 2012-10-31 Impact factor: 2.459
Authors: Patrick Thiebaud; Michael Demand; Scott A Wolf; Linda L Alipuria; Qin Ye; Peter R Gutierrez Journal: Diabetes Care Date: 2008-06-03 Impact factor: 19.112