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Self-Management Program Helps Diabetics


Diabetics taking part in the Diabetes Ten City Challenge showed improvement across all key clinical and satisfaction indicators in the early stages of the program, according to a preliminary report released this week by the American Pharmacists Association (APhA).

The challenge is an employer-based diabetes self-management program that was launched in October 2005. The 31 participating employers in 10 cities work with hundreds of pharmacists to help more than 1,000 people manage their diabetes. The program is supported by drug maker GlaxoSmithKline.

Through the challenge, employers establish a voluntary health benefit for workers, dependents and retirees with diabetes, and waive co-payments for diabetes medications and supplies if participants work with a pharmacist “coach” to manage their condition in collaboration with their doctors and diabetes educators.

The preliminary report includes an analysis of data on 914 people who took part in the challenge for at least three months as of Sept. 30, 2007. The report found clinical improvements in all recognized standards for diabetes care, including:

Decreases in laboratory measures (mean) for hemoglobin A1C (a laboratory test showing 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.
A 21 percent increase in the number of participants achieving the American Diabetes Association goal of A1C level of less than 7.0.
An increase from 43.8 percent to 57.7 percent of participants achieving National Cholesterol Education Program goals for LDL cholesterol.
A 15.7 percent increase in the number of participants achieving recognized goals for systolic blood pressure.
“The results to date prove that this collaborative-practice model is effective for managing diabetes and replicable in diverse locations and employers,” interim report co-author William M. Ellis, chief executive officer of the APhA Foundation, said in a prepared statement. “In years of experience with this model, we have seen that when you have positive clinical outcomes and increased patient satisfaction in the early states, the economic benefits follow.”

The preliminary report appears in the March/April issue of the Journal of the American Pharmacists Association. The final report, which will include data on cost savings to employers, will be issued in 2009.

Diabetes, which affects 21 million Americans, costs the United States more than $174 billion a year and is the country’s sixth leading cause of death, according to background information in a news release about the preliminary report.



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