257996 Expanding successful telephonic diabetes self-management education (DSME) program to persons with co-occurring cardiovascular disease

Monday, October 29, 2012

Jo-Anne Bushey, RN, MSN , Division of Public Health, Medical Care Development, Inc., Augusta, ME
     
Background: In 1995 Medical Care Development, Inc. (MCD) developed the Telephonic Diabetes Education and Support Programİ (TDESİ) in partnership with Maine employers. This program is found to overcome barriers to traditional diabetes education (DSME) reported by Maine CDC: aversion to group classes, did not feel need, inconvenience, and transportation challenges. MCD trained diabetes educators at 25 hospital-based diabetes programs to deliver standard DSME curriculum, integrate self-management tools from an evidenced based model, and collect Pre- and Post- intervention outcomes measures telephonically. Employers waived participants' co-pays for diabetes medication/supplies. TDESİ average participation rate of 10% exceeds the 3% participation rate for traditional Maine DSME. Participants report high to very high satisfaction, increased self-care knowledge and confidence, health and health care improvements,increases in medication adherence and use of preventive care services. Independent 2008 analysis estimated savings of $1300/participant/year. Objectives: Having identified co-occurring cardiovascular risk in the population, in 2011 MCD tested whether telephonic delivery could better serve participants by extending content to focus on self-managing multiple chronic diseases. Methods: Diabetes educators were given advanced training and enhanced materials to support persons self-managing diabetes with hypertension and/or dyslipidemia. Employers expanded pharmacy copayment waiver to cardiovascular medications. Enhanced evaluation measured barriers to meeting individual health goals. Results: This group showed increased access to DSME, improved health and optimum health care use. All barriers to meeting individual action plans decreased during the intervention, although three remained high: Cost, Multiple Diagnosis/treatments, and Grief/Depression. These persistent needs and challenges suggest next steps for continued program development.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs

Learning Objectives:
1. Recognize how the telephonic modality offers a means to increase access to education and support for self-managing diabetes and cardiovascular disease. 2. Identify elements of partnerships with employers that support improved health and optimum health care use 3. Compare barriers to successful individual health action plans

Keywords: Chronic Diseases, Self-Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have many years experience in designing, implementing, and evaluating services that support healthy behaviors and self-care in the full range of settings. I have served as project manager at Medical Care Development these past five years, developing the Telephonic Diabetes Education and Supportİ Program from a pilot to a fully instituted service. This includes managing program outreach, enrollment, data analysis, and interpretation.
Any relevant financial relationships? No

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.

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