Nicole D White1, Thomas L Lenz2, Maryann Z Skrabal1, Jessica J Skradski3, Louis Lipari4. 1. Associate Professor, Pharmacy Practice, Creighton University School of Pharmacy and Health Professions, Omaha, NE. 2. Professor, Pharmacy Practice, Creighton University School of Pharmacy and Health Professions, Omaha, NE. 3. Assistant Professor, Pharmacy Practice, Creighton University School of Pharmacy and Health Professions, Omaha, NE. 4. PharmD candidate, Creighton University School of Pharmacy and Health Professions, Omaha, NE.
Abstract
BACKGROUND: Cardiovascular disease remains the leading cause of death in America and poses a significant challenge for self-insured employers attempting to improve employee health and well-being while controlling healthcare costs. Disease state management programs can be an effective means of achieving these outcomes, but the durability and long-term effects of such programs have limited evaluation. OBJECTIVE: To assess the 5-year health, economic, and quality-of-life patient outcomes of an employer-sponsored disease state management program. METHODS: This was a longitudinal, 5-year, quasi-experimental, pre-/postenrollment study. Self-insured health plan members with hypertension, hyperlipidemia, diabetes, or a combination of these conditions met with a pharmacist regularly (monthly for the first year, then varied by participant) to implement lifestyle medicine programs, optimize medication therapy, and facilitate the coordination of care. Biometric markers, lifestyle behaviors, quality of life, and work productivity were assessed on an annual basis. RESULTS: The significant biometric improvements (mean) seen after 5 years of program participation compared with pre-enrollment included decreased low-density lipoprotein cholesterol levels (96.71 mg/dL vs 84.83 mg/dL, respectively), increased high-density lipoprotein cholesterol levels (39.32 mg/dL vs 46.12 mg/dL), and decreased systolic blood pressure (132.04 mm Hg vs 123.63 mm Hg) and diastolic blood pressure (85.75 mm Hg vs 75.83 mm Hg). The average exercise time increased (50 minutes weekly vs 156.04 minutes weekly), as did fruit and vegetable consumption (3.98 servings daily vs 5.27 servings daily). The program participants reported improved general health and a reduced number of unhealthy days. The combined healthcare and productivity return on investment for the program at 5 years was $9.64 for every $1 invested. CONCLUSIONS: Significant changes in employees' health, well-being, and health-related costs are possible through sustained participation in an employer-sponsored disease state management program.
BACKGROUND: Cardiovascular disease remains the leading cause of death in America and poses a significant challenge for self-insured employers attempting to improve employee health and well-being while controlling healthcare costs. Disease state management programs can be an effective means of achieving these outcomes, but the durability and long-term effects of such programs have limited evaluation. OBJECTIVE: To assess the 5-year health, economic, and quality-of-life patient outcomes of an employer-sponsored disease state management program. METHODS: This was a longitudinal, 5-year, quasi-experimental, pre-/postenrollment study. Self-insured health plan members with hypertension, hyperlipidemia, diabetes, or a combination of these conditions met with a pharmacist regularly (monthly for the first year, then varied by participant) to implement lifestyle medicine programs, optimize medication therapy, and facilitate the coordination of care. Biometric markers, lifestyle behaviors, quality of life, and work productivity were assessed on an annual basis. RESULTS: The significant biometric improvements (mean) seen after 5 years of program participation compared with pre-enrollment included decreased low-density lipoprotein cholesterol levels (96.71 mg/dL vs 84.83 mg/dL, respectively), increased high-density lipoprotein cholesterol levels (39.32 mg/dL vs 46.12 mg/dL), and decreased systolic blood pressure (132.04 mm Hg vs 123.63 mm Hg) and diastolic blood pressure (85.75 mm Hg vs 75.83 mm Hg). The average exercise time increased (50 minutes weekly vs 156.04 minutes weekly), as did fruit and vegetable consumption (3.98 servings daily vs 5.27 servings daily). The program participants reported improved general health and a reduced number of unhealthy days. The combined healthcare and productivity return on investment for the program at 5 years was $9.64 for every $1 invested. CONCLUSIONS: Significant changes in employees' health, well-being, and health-related costs are possible through sustained participation in an employer-sponsored disease state management program.
Authors: Terry A Jacobson; Matthew K Ito; Kevin C Maki; Carl E Orringer; Harold E Bays; Peter H Jones; James M McKenney; Scott M Grundy; Edward A Gill; Robert A Wild; Don P Wilson; W Virgil Brown Journal: J Clin Lipidol Date: 2014-07-15 Impact factor: 4.766
Authors: S H Simpson; D A Lier; S R Majumdar; R T Tsuyuki; R Z Lewanczuk; R Spooner; J A Johnson Journal: Diabet Med Date: 2015-02-02 Impact factor: 4.359
Authors: Ralph B D'Agostino; Ramachandran S Vasan; Michael J Pencina; Philip A Wolf; Mark Cobain; Joseph M Massaro; William B Kannel Journal: Circulation Date: 2008-01-22 Impact factor: 29.690
Authors: Nicole D White; Thomas L Lenz; Maryann Z Skrabal; Michele A Faulkner; Jessica J Skradski; Leslie A Southard; Derek E Popken Journal: J Am Pharm Assoc (2003) Date: 2013 Jul-Aug
Authors: Caroline S Fox; Sherita Hill Golden; Cheryl Anderson; George A Bray; Lora E Burke; Ian H de Boer; Prakash Deedwania; Robert H Eckel; Abby G Ershow; Judith Fradkin; Silvio E Inzucchi; Mikhail Kosiborod; Robert G Nelson; Mahesh J Patel; Michael Pignone; Laurie Quinn; Philip R Schauer; Elizabeth Selvin; Dorothea K Vafiadis Journal: Circulation Date: 2015-08-05 Impact factor: 29.690