Team-based approach improves diabetes care

Armen Hareyan's picture
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Diabetes Treatment Research

Due to the success of the first three years of the American College of Physicians (ACP) and the American College of Physicians Foundation (ACPF) Diabetes Initiative, the program has received additional funding from Novo Nordisk Inc. to continue the initiative for an additional two years through December 2009.

"The results of the first three years of our efforts confirm that optimal diabetes care requires a team effort," says Vincenza Snow, MD, FACP, director of clinical programs and quality of care at ACP. "We are excited to have the opportunity to continue producing programs and products that will improve the health and quality of life for people with diabetes."

Launched in 2005 and funded by an unrestricted educational grant from Novo Nordisk, as part of its Changing Diabetes(sm) initiative, the ACP and ACPF Diabetes Initiative offers educational tools and practice-based, team-oriented training for physicians, patients, and health care teams.

The goals of the initiative include increasing awareness of the gap between current practice and acceptable standards of diabetes care among internists; increasing internists' awareness of what constitutes high quality, evidence-based diabetes care; and providing educational tools to improve diabetes treatment.

Practice-Based, Team-Oriented Training Results For Diabetes Treatment

To date, 60 team participants from 19 physician practices caring for a total of 1,300 patients with diabetes have participated in ACP's "Closing the Gap" module for diabetes, a program that seeks to close the gap between clinical evidence and best practices and the care actually provided in a physician's office. The practice-based, team-oriented program trains teams - usually an internist, a nurse, and a staff assistant - to improve the quality of care for patients with chronic diseases.

This team-based approach has resulted in statistically significant improvements in many clinical measures such as a nearly 50 percent improvement in the average number of days between patient office visits for diabetes (from 115 days to 58), a 40 percent increase in annual urine albumin testing, a 62 percent increase in annual dilated eye exams (29 percent to 47), and a 100 percent increase in influenza vaccinations (26 percent to 52). Other important improvements were seen in patients' lipids levels such as lower total cholesterol and LDL cholesterol.

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"The Diabetes Initiative on Closing the Gap has proven it is changing diabetes at its most critical stages: the interface between patient and the care delivery team. By assessing the risk for complications or identifying complications earlier, these complications can be checked and treated appropriately, potentially reducing the long-term consequences of diabetes," said Alan Moses, MD, chief medical officer worldwide for Novo Nordisk A/S. "We are delighted to see that the type of partnership forged between Novo Nordisk and ACP can directly impact patient care through restructuring the way diabetes care is delivered and through the development of new patient and physician educational tools."

Educational Tools Results

Last year, ACP and ACPF produced three educational tools for practicing internists, other health care professionals on clinical practice teams, and their patients:

  • "Living With Diabetes: An Everyday Guide for You and Your Family" - a self-management guide designed for patient education and empowerment.

  • "The ACP Diabetes Care Guide" -for use by physicians and multi-disciplinary teams providing care to patients with diabetes.

  • The Diabetes Portal - a free Web-based resource for physicians and patients that provides tools, resources, and research supporting diabetes care.

To date, ACP and ACPF have distributed more than 500,000 patient guides and more than 80,000 clinical care guides.

Since the launch of the Diabetes Portal in June 2007, more than 20,000 unique users have visited the site for over 1.5 million page hits, an average of 75,000 hits per week. The most popular content includes slides and audio files from Internal Medicine 2007 and previous ACP annual meetings, information about drug therapy, and tools to assist practices in implementing team-based care.

Additionally, professional organizations and societies such as the American Diabetes Association and the American Nurses Association, federal and state agencies, academic centers and residency programs, and private health systems and practices have utilized the resources developed through the initiative.

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