The data show significant improvement in all clinical and diabetes care indicators measured
Washington, D.C. (Vocus) March 12, 2008
Interim results published in the March/April issue of the Journal of the American Pharmacists Association (JAPhA) show that participants in the Diabetes Ten City Challenge (DTCC) improved across all key clinical and patient satisfaction indicators in the early stages of the program, the American Pharmacists Association (APhA) Foundation announced today.
Initial data show a positive trend in controlling diabetes, the chronic disease that affects 21 million Americans, costs the United States more than $174 billion annually and is the sixth leading cause of death in the U.S. The final DTCC report, due out in 2009, will include cost-savings data for DTCC employers.
The Diabetes Ten City Challenge (DTCC) is an employer-based diabetes self-management program conducted by APhA Foundation with support from GlaxoSmithKline. Since it was launched in October 2005, 31 employers in ten cities have joined forces with hundreds of pharmacists to help more than 1,000 people manage their diabetes.
Through the DTCC, employers establish a voluntary health benefit for employees, dependents and retirees with diabetes, and waive co-payments for diabetes medications and supplies if they work with a pharmacist “coach” to manage their condition in collaboration with their doctors and diabetes educators. The DTCC is modeled after other highly successful APhA programs that have proven to improve overall health, reduce absenteeism, shorten hospital stays and reduce health care costs.
The report released today analyzed aggregate data on 914 DTCC participants who were in the program at least three months as of September 30, 2007. It documented clinical improvements in all the recognized standards for diabetes care, including:
- Decreases in laboratory measures (mean) for hemoglobin A1C (a laboratory test showing the patient’s average blood sugar control over the previous two to three months), LDL cholesterol and blood pressure over the initial year of the program
- Increases in the number of participants with current influenza vaccinations, foot examinations and eye examinations
- 21% increase in the number of participants achieving the American Diabetes Association goal of A1c level < 7.0
- Increase from 43.8% to 57.7% in participants achieving nationally recognized National Cholesterol Education Program goals for LDL cholesterol
- 15.7% increase in the number of people achieving recognized goals for systolic blood pressure
Other Key Data
- The number of DTCC participants who felt their overall diabetes care was “very good to excellent” increased from 39% to 87%
- More than 97% of participants reported being “very satisfied” or “satisfied” with diabetes care provided by DTCC pharmacists
- The number of participants setting self-management goals to control their diabetes also increased significantly: those with nutrition goals increased from 22% to 66%; those with weight goals increased from 23% to 64%; and the number of participants setting exercise goals increased from 24% to 72%
“The results to date prove that this collaborative-practice model is effective for managing diabetes and replicable in diverse locations and employers,” said William M. Ellis, CEO of the APhA Foundation and co-author of the peer-reviewed interim data article. “In years of experience with this model we have seen that when you have positive clinical outcomes and increased patient satisfaction in the early stages, the economic benefits follow.”
How the DTCC Model Works
The APhA Foundation contracts with employers, helps establish local pharmacist networks and provides software and data analysis for the DTCC. Employers offer the voluntary employee benefit and compensate pharmacists for the care provided. Participating pharmacists, who are specially trained in diabetes care educate participants on diabetes, diet and nutrition. These “pharmacist coaches” meet with participants regularly to help them track key diabetes indicators and manage their diabetes by eating right, exercising regularly, visiting their doctors and taking medications as prescribed.
Physicians are informed of participants’ enrollment and are encouraged to share individual patient care plans with the pharmacist, who reinforces those plans in personal meetings. Pharmacists communicate with physicians after every visit and refer patients to other health care providers as needed for additional care or education.
“The data show significant improvement in all clinical and diabetes care indicators measured,” said APhA Foundation Director of Patient Self-Management Programs and principal author of the JAPhA article, Toni Fera, PharmD. “These results are consistent with data from past projects where similar clinical improvements translated to annual savings to employers in total direct medical costs for participants.”
Expanding the DTCC Model for all Chronic Diseases
An additional 50 employers and 1,300 employees are using the DTCC model through the APhA Foundation’s HealthMapRx™ to manage many chronic diseases, such as diabetes and cardiovascular disease.
“The Diabetes Ten City Challenge provides an opportunity to transform health care delivery in local communities and drive fundamental change in the U.S. health care system,” Ellis said. “Our overall goal is to make this model as widely available as possible and encourage employers to invest in helping their employees manage all chronic conditions. Our nation’s health care system is broken - we need more programs that are an investment in wellness rather than an expense for sickness.”
“Chronic diseases like diabetes are threatening the stability of our healthcare system,” said GlaxoSmithKline President of U.S. Pharmaceuticals, Chris Viehbacher. “By focusing on patients and helping them to better understand and self-manage their condition, we can improve their health and lower costs. GSK is proud to support the Diabetes Ten City Challenge because it is a model that works and can be replicated.”
About the APhA Foundation
The American Pharmacists Association (APhA) Foundation, headquartered in Washington, D.C., is a non-profit organization affiliated with the American Pharmacists Association, the national professional society of pharmacists in the United States. The APhA Foundation has expertise in designing programs that seek to create a new medication use system in the U.S. where patients, pharmacists, physicians and other health care providers collaborate to dramatically improve the cost and quality of consumer health outcomes through the safe and effective use of medications.
Caren Kagan Evans