Transcript Presentation

Improving Patient Outcomes in Diabetes
Matt Petersen
Managing Director, Medical Information & Professional
Engagement
American Diabetes Association
Improving Patient Outcomes
Trends in age-standardized rates of diabetes-related complications among U.S.
adults with diabetes, 1990-2010
Acute MI
Stroke
Amputation
ESRD
Death from Hyperglycemic Crisis
140
Cases/10,000 persons
120
100
80
60
-52.9%
-67.8%
40
20
-51.4%
-28.3%
0
-64.4%
1990
1995
Gregg et al. N Engl J Med 370: 1514—1523, 2014
2000
2005
2010
Improving Patient Outcomes
1. Improve A1C and other measures of quality
care
2. HCP tools to make that happen
3. Supporting patient resources
Case Study: Diabetes Inside
• 403 randomly selected patients with diabetes
• 13% at goal:
–
–
–
–
–
A1C <8%
LDL <100 mg/dL
BP <130/90 mmHg
Aspirin therapy if indicated
Non-smoker
ADA Resources for Intervention
• HCP:
Grand Rounds presentation and
referral to ADA Standards of Medical
Care
–
–
–
–
Intensified glucose control
Foot exams
Referral to diabetes education
Adequate follow-up
• Patient:
Living With Type 2 Diabetes
HCP Insulin Attitude Survey
• Clinician agreement on insulin barriers and
benefits
• Lack of consensus on the role of insulin
– Implies important knowledge gaps and confusion
Second Grand Round
810 T2D patients with A1C >7%
• 39% A1C >9%
• No variation among individual
providers
Patients with Diabetes
A1C>9%
A1C 8-8.9%
A1C 7-7.9%
Type 2 Treatment Algorithm
© American Diabetes Association 2016
Insulin Workshop Follow-up
Attended workshop
Yes
No
More aggressive
medications/insulin initiation
Referral to DISH/group class/health
coach/pharmacist
More frequent patient followup
More diligent with pt education
0%
10%
20%
30%
40%
50%
60%
70%
Actions to Improve Glycemic Control
Yes
Attended workshop?
No
Actions to Improve Glycemic Control
Attended workshop?
Yes
No
Case Study Results
57% of patients with reduced A1C
• Earlier insulin initiation
• More aggressive oral therapy
• Higher use of patient education and community
programs
Case Study Conclusion
• Data analysis + visualization
• Nationally endorsed messages
• Non-judgmental environment
• Entire clinical care team
ADA resources for professionals and patients
ADA resources for professionals and patients
ADA Health Care Professional Tools
ADA Health Care Professional Tools
Professional Education
• Self-assessment programs
• Webcasts
• Point of Care
• Local events
Diabetes Self-Management Education
• Recognized program
• DSME referral algorithm
• Education resources
• Chronical Diabetes
HCP Resources for Patients
Print resources:
• Living With Type 2 Diabetes
• Patient education library
ADA Online Resources
My Food Advisor
Create Your Plate
Diabetes 24/7
For the Workplace
• Wellness Lives Here
– Health Champion Designation
• Mission Engagement Days
• Stop Diabetes @ Work
• Signature Physical Activity Events
Patient Resources
National resources:
• diabetes.org
• 800-DIABETES
• Diabetes Forecast
Local resources:
• Local page on diabetes.org
• 888-DIABETES
professional.diabetes.org