236728 An evaluation of the impact of a physician-led health adherence program on diabetes outcomes

Tuesday, November 1, 2011: 1:05 PM

Ted Triana, DO , Compassionate Family Medicine, Syracuse, NY
Frankie Quarles, DO , Compassionate Family Medicine, Syracuse, NY
Maria Cannito, PharmD, MS , Medical Outcomes Specialists, Pfizer, Inc, Pittsford, NY
  
Maintaining adherence to diabetes therapy is a key strategy to achieving long-term glycemic control, however levels of non-adherence to prescribed regimens ranges from 9-80%. One factor that could influence adherence is poor health literacy. Ethnic minority groups, older patients, and those with low socioeconomic status are especially vulnerable. Possible consequences include inability to understand medication directions, information on appointment slips and ineffective treatment of chronic and acute conditions. This retrospective, HIPPA-compliant analysis utilized EMR data to evaluate a physician-led education program for underserved, non-adherent diabetic patients (n=35). A customized education program included disease, medication and activities of daily living topics. Outcome measures included: HbA1c, blood pressure, LDL cholesterol, eye, foot, nephropathy assessments, smoking status, influenza, pneumococcal vaccinations, oral cancer screening. Data analysis revealed an overall decrease in HbA1c (- 4.5%), with a decrease in patients with less than a high school education (-4.0%) and in Spanish-speaking patients (-2.0%). Additional analysis revealed a decrease in patients attending all educational sessions (-9.6%) and in patients who missed <2 lab visits (-3.9%). In this era of public healthcare reform,

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
Discuss the importance of adherence to diabetes treatment outcomes for those practices that provide health care to the underserved and non-adherent patient population. Assess the impact of an in-house, physician-led, intensive diabetes health education program. Formulate communication including patient education around expectations of diabetes treatment, value of adherence to medication and modification of activities of daily living. Evaluate how socioeconomic disparities influence treatment outcomes and number of missed education and lab appointments. Assess the impact and importance of an electronic medical records system in the pursuit for meaningful use, and to target and extract outcomes in the high-risk, underserved patient population. Discuss the importance of community-based health promotion.

Keywords: Adherence, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I work to provide disease state education and awareness initiatives; conceptualize, implement and measure the effects of Quality Improvement activities; perform appropriate data analyses; plan, develop and implement patient-centric health initiatives.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Pfizer, Inc. Medical Outcomes Employment (includes retainer)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Epidemiology potpourri session 1
See more of: Epidemiology