Sherita Hill Golden1,2, Nisa Maruthur3,4, Nestoras Mathioudakis5, Elias Spanakis6, Daniel Rubin7, Mihail Zilbermint5,8,9, Felicia Hill-Briggs5,4,10. 1. Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Suite no. 333, Baltimore, MD, 21287, USA. sahill@jhmi.edu. 2. Departments of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. sahill@jhmi.edu. 3. Departments of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. 4. Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Suite no. 333, Baltimore, MD, 21287, USA. 6. Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland Medical System, Baltimore, MD, USA. 7. Division of Endocrinology and Metabolism, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA. 8. Johns Hopkins Community Physicians at Suburban Hospital, Bethesda, MD, USA. 9. Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA. 10. Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Abstract
PURPOSE OF REVIEW: The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. RECENT FINDINGS: Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems. Effective outpatient interventions that improve diabetes control and process outcomes are multi-level, targeting the patient, provider, and healthcare system simultaneously and integrate community health workers as a liaison between the patient and community-based healthcare resources. A multi-faceted approach to diabetes management is also effective in the inpatient setting. Interventions shown to promote safe and effective glycemic control and use of evidence-based glucose management practices include provider reminder and clinical decision support systems, automated computer order entry, provider education, and organizational change. Future studies should examine the cost-effectiveness of multi-faceted outpatient and inpatient diabetes management programs to determine the best financial models for incorporating them into diabetes population health strategies.
PURPOSE OF REVIEW: The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. RECENT FINDINGS: Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems. Effective outpatient interventions that improve diabetes control and process outcomes are multi-level, targeting the patient, provider, and healthcare system simultaneously and integrate community health workers as a liaison between the patient and community-based healthcare resources. A multi-faceted approach to diabetes management is also effective in the inpatient setting. Interventions shown to promote safe and effective glycemic control and use of evidence-based glucose management practices include provider reminder and clinical decision support systems, automated computer order entry, provider education, and organizational change. Future studies should examine the cost-effectiveness of multi-faceted outpatient and inpatient diabetes management programs to determine the best financial models for incorporating them into diabetes population health strategies.
Entities:
Keywords:
Cost-effectiveness; Diabetes mellitus; Diabetes prevention; Inpatient diabetes; Multi-level diabetes interventions; Population health
Authors: Daniel J Rubin; Elizabeth A Handorf; Sherita Hill Golden; Deborah B Nelson; Marie E McDonnell; Huaqing Zhao Journal: Endocr Pract Date: 2016-10 Impact factor: 3.443
Authors: Sherita Hill Golden; Arleen Brown; Jane A Cauley; Marshall H Chin; Tiffany L Gary-Webb; Catherine Kim; Julie Ann Sosa; Anne E Sumner; Blair Anton Journal: J Clin Endocrinol Metab Date: 2012-06-22 Impact factor: 5.958
Authors: Sherita Hill Golden; Daniel Hager; Lois J Gould; Nestoras Mathioudakis; Peter J Pronovost Journal: Jt Comm J Qual Patient Saf Date: 2016-10-13
Authors: X R Pan; G W Li; Y H Hu; J X Wang; W Y Yang; Z X An; Z X Hu; J Lin; J Z Xiao; H B Cao; P A Liu; X G Jiang; Y Y Jiang; J P Wang; H Zheng; H Zhang; P H Bennett; B V Howard Journal: Diabetes Care Date: 1997-04 Impact factor: 19.112
Authors: Rebekah R Jacob; Renee G Parks; Peg Allen; Stephanie Mazzucca; Yan Yan; Sarah Kang; Debra Dekker; Ross C Brownson Journal: Front Public Health Date: 2022-04-28
Authors: Karly A Murphy; Raquel C Greer; Debra L Roter; Deidra C Crews; Patti L Ephraim; Kathryn A Carson; Lisa A Cooper; Michael C Albert; L Ebony Boulware Journal: J Gen Intern Med Date: 2019-11-12 Impact factor: 5.128
Authors: Rachel G Tabak; Renee G Parks; Peg Allen; Rebekah R Jacob; Stephanie Mazzucca; Katherine A Stamatakis; Allison R Poehler; Marshall H Chin; Maureen Dobbins; Debra Dekker; Ross C Brownson Journal: BMJ Open Diabetes Res Care Date: 2018-09-05
Authors: Letizia Trevisi; John E Orav; Sidney Atwood; Christian Brown; Cameron Curley; Caroline King; Olivia Muskett; Hannah Sehn; Katrina A Nelson; Mae-Gilene Begay; Sonya S Shin Journal: Int J Equity Health Date: 2019-11-27
Authors: C Bamuya; J C Correia; E M Brady; D Beran; D Harrington; A Damasceno; A M Crampin; Ana Magaia; Naomi Levitt; M J Davies; M Hadjiconstantinou Journal: BMC Public Health Date: 2021-07-08 Impact factor: 3.295