Impact of telephonic interventions on glycosylated hemoglobin and low-density lipoprotein cholesterol testing

To determine whether diabetes disease management (DM) programs are able to improve adherence to glycosylated hemoglobin (A1C) and low-density lipoprotein cholesterol (LDL-C) clinical testing in a nonadherent population and to quantify the efficacy of telephonic interventions in improving clinical te...

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Veröffentlicht in:The American journal of managed care 2007-04, Vol.13 (4), p.188-192
Hauptverfasser: Coberley, Carter, Hamar, Brent, Gandy, Bill, Orr, Patty, Coberley, Sadie, McGinnis, Matthew, Hudson, Laurel, Forman, Sam, Shurney, Dexter, Pope, James
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Sprache:eng
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Zusammenfassung:To determine whether diabetes disease management (DM) programs are able to improve adherence to glycosylated hemoglobin (A1C) and low-density lipoprotein cholesterol (LDL-C) clinical testing in a nonadherent population and to quantify the efficacy of telephonic interventions in improving clinical testing rates. Retrospective, observational cohort study before and after DM program implementation. A baseline cohort of members with diabetes (n = 5640) was identified from among large-scale diabetes DM programs administered for 13 geographically diverse health plans. Members were defined by nonadherence at baseline to A1C and/or LDL-C testing, grouped together based on how long they had participated in the program, divided retrospectively into telephonically contacted and uncontacted groups, and analyzed in the subsequent 12-month implementation period for testing rates. Subgroups defined by disease burden at baseline and frequency of telephonic interactions were analyzed to determine achievement of guideline-based A1C and LDL-C testing rates. Participation in diabetes DM programs was associated with improved A1C and LDL-C testing rates in previously nonadherent members. Calling nonadherent members improved A1C testing by 30.2% and LDL-C testing by 10.9% compared with testing rates for members who were not called. Members with high disease burden benefited even more from the diabetes intervention. Frequency of telephonic contacts with nonadherent individuals demonstrated a linear relationship with improved rates of adherence to A1C and LDL-C testing guidelines, and markedly improved testing rates compared with a not-called group. Telephonic interventions as part of comprehensive DM programs are associated with improved disease-monitoring testing.
ISSN:1088-0224
1936-2692