Multiple diabetes pilot programs and projects provide a unique opportunity to improve the health of constituents with diabetes and directly contain costs related to the disease. Notable pilots have developed self-management programs that engage people living with diabetes to change their health behaviors and minimize health risks.
Diabetes Self Management Support Programs
Patient Self-Management Support Programs: An Evaluation
Authors: RAND Health
Source: The American Health Quality Association
Providing support to people with a chronic illness, such as diabetes, can improve health outcomes. The report suggests that while education affects patient knowledge it did not affect their self-management behaviors. This report also notes the importance of other factors such as: social support; motivation; environmental obstacles; and adjustment to diagnosis as contributing to changes in self behavior. Current self-management programs use education and individualized approaches through interactions with a nurse, social worker, or other professional.
Self-management support programs are built with the intention of containing healthcare cost and improve health outcomes for people living with chronic disease. This report describes multiple self-management programs used by health plans, insurers, employers, public providers, and payers (such as Medicaid) to improve quality of care for patients with diabetes.
Source: Pearson ML, Mattke S, Shaw R, Ridgely MS, Wiseman SH. Patient Self-Management Support Programs: An Evaluation. Final Contract Report (Prepared by RAND Health under Contract No. 282-00-0005). Rockville, MD: Agency for Healthcare Research and Quality; November 2007. AHRQ Publication No. 08-0011.
Community Pharmacies in Diabetes Care
The Role of Community Pharmacies in Diabetes Care: Eight Case Studies
Author and Source: California Healthcare Foundation
This report highlights innovations and special qualities of community pharmacies. Many community pharmacies provide services for people with chronic diseases, such as diabetes. Pharmacies can assist patients in managing their care. Diabetes patients frequently visit their pharmacist each month to purchase supplies and medication. In addition, pharmacists located in low-income ethnic communities often understand and speak the same language as their customers. As a result, community pharmacists are in a good position to influence health behaviors. Current diabetes pilots include the use of specially-trained pharmacist that educate and encourage patients to better self-manage their disease.
National Community Pharmacists Association
The National Community Pharmacists Association is a network of owners of more than 23,000 pharmacies.
Sample Projects and Programs
Together on Diabetes
Bristol-Myers Squibb Foundation is sponsoring the Together on Diabetes initiative. This $100 million initiative will target populations disproportionately affected by diabetes type 2. By drawing collaboration from public and private sector partnerships, the Together on Diabetes initiative will strengthen programs in self-management education, broad-based community mobilization, and community-based support services that address disparities.
The Diabetes Ten City Challenge
The Diabetes Ten City Challenge (DTCC) is a diabetes self-management program modeled after successful diabetes projects such as the Asheville Project in North Carolina. Thirty employers in ten cities established a voluntary health benefit for their employees, family members, and retirees with diabetes.
Participants received incentives to better manage their diabetic needs. Benefits included: waived co-pays for diabetes medication and supplies; consulting with specially-trained pharmacists to assist in medication management; and assistance in monitoring and controlling diabetes through diet, exercise, and lifestyle changes.
As a result, cities implementing the DTCC saw their average total healthcare costs reduced by $1,079 per patient annually when compared to projected costs if the DTCC were not implemented. Participants who stayed in the program an average of 14.8 months had significant improvements in health measures. Twenty-three percent of these participants achieved American Diabetes Association goals.
The DTCC was conducted by the American Pharmacists Association (APhA) Foundation through HealthMapRx,™ with support from GlaxoSmithKline. It was implemented by multiple cities including: Charleston, SC; Spartanburg, SC; Cumberland, MD; Chicago, IL; Colorado Springs, CO; Dalton, GA; Honolulu, HI; Los Angeles, CA; Milwaukee, WI; Pittsburgh, PA; and Tampa Bay, FL. For more information click here.
The Asheville Project
Employees from the city of Asheville, NC, with various chronic conditions were given intensive education and the opportunity to meet with a community pharmacist to help manage their disease. Pharmacists then developed patient care services that ultimately led to lower glucose blood tests for patients, fewer sick days, and lower healthcare costs overall. The Asheville project is a payer-driven and patient-centered model that has served as the inspiration for new healthcare models addressing chronic health diseases today.
Research done through the Asheville Project indicates that when patients understand their role in diabetes management, they take a more active role in their health. This can lead to achieving significant improvements in adhering to diabetes care. By engaging those with diabetes and providing incentives that help a person manage their medical needs; people become more active in improving their lifestyle and their health.