Disease Management : Dm最新文献

{"title":"Application of an Outcome-Directed Behavioral Modification Model for Obesity on a Telephonic/Web-Based Platform","authors":"Ryan Sorrell","doi":"10.1089/DIS.2007.7716","DOIUrl":"https://doi.org/10.1089/DIS.2007.7716","url":null,"abstract":"This study assessed intervention results from 205 individuals enrolled in a telephonic weight management program. Average weight of enrolled participants was 270 pounds with an average body mass index (BMI) of 44. The study was an initial program assessment of multiple outcome areas including weight loss, behavior change, global distress, and productivity. The study used pre and post client self-reported information to assess these areas. The average participant in the program lost 8 pounds, or 3% of intake weight, which represents a strong trend toward expected results (p = .08 one-tailed t-test). Other encouraging results include significant improvement in distress, improvement in absenteeism and presenteeism, as well as increases in healthy behaviors such as nutrition and exercise plans. This article will highlight an online outcomes management system that enables the program participant and service provider to assess appropriate level of care, effectiveness of services, and likelihood of success. This...","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2007-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/DIS.2007.7716","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60961640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Weight Management in a Corporate Environment","authors":"Linda Schuessler, J. Beyer, E. Mischler","doi":"10.1089/DIS.2007.7714","DOIUrl":"https://doi.org/10.1089/DIS.2007.7714","url":null,"abstract":"Fiserv, Inc., a company of 22,000 employees, conducted a health risk assessment in the fall of 2004 that revealed that fewer than 20% of employees and their spouses were getting recommended physical activity and two thirds were overweight or obese, posing potentially large cost consequences for the company. In October 2005, a 4,000-employee division of Fiserv, Inc. launched a pilot of the Healthy You Fitness Challenge for employees. During the 10-week challenge, employees formed teams to track minutes of physical activity and weight. Incentives for participation included a cash prize of $2,500 for the top team and either a half or full day off from work for those who met set goals. The challenge drew 1933 employees or 48% participation. Altogether 82% of participants met goals to win a full day (78%) or a half day (4%) off. In a post-challenge survey, 96% reported moderate or greater daily activity compared to 62% in the pre-challenge survey, 14% reported reduction in chronic disease medications, 70% said...","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2007-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/DIS.2007.7714","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60962037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cherry-Picking for Obesity Programs: Out of Season","authors":"Ted R. Borgstadt","doi":"10.1089/DIS.2007.7713","DOIUrl":"https://doi.org/10.1089/DIS.2007.7713","url":null,"abstract":"Sierra Pacific Industries began a comprehensive weight management and obesity management program on February 1, 2006 with their chosen vendor, TrestleTree, Inc. TrestleTree provided an intense health coaching intervention for all 132 participants, regardless of a participant's diagnosed low motivation to change exercise or diet habits. Seventy percent of the participants lost weight, 15% had no weight change, and 15% gained weight. The average weight loss ranged from 19 pounds (11-month average participation) to 11 pounds (6-month average participation). The increase in the percent of people exercising at the minimum standard of 30 minutes, 3 times a week, increased from 5% to 20%, while the increase for those individuals exercising at a subminimum standard increased from 19% to 41%. Decreases in biometrics also were documented; blood pressure decreased from an average of 131/80 to 127/75, and fasting blood glucose decreased from 166 to 129. The program showed that meaningful outcomes in weight loss, biom...","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2007-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/DIS.2007.7713","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60962016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health services outcomes for a diabetes disease management program for the elderly.","authors":"Gregory D Berg,&nbsp;Sandeep Wadhwa","doi":"10.1089/dis.2007.104704","DOIUrl":"https://doi.org/10.1089/dis.2007.104704","url":null,"abstract":"<p><p>Our objective was to investigate the utilization, drug, and clinical outcomes of a telephonic nursing disease management (DM) program for elderly patients with diabetes. We employed a 24-month, matched-cohort study employing propensity score matching. The setting involved Medicare + Choice recipients residing in Ohio, Kentucky, and Indiana. There were 610 intervention group members over the age of 65 matched to a control group of members over the age of 65. The DM diabetes program employed a structured, evidence-based, telephonic nursing intervention designed to provide patient education, counseling, and monitoring services. Measurements consisted of Medical service utilization, including hospitalizations, emergency department visits, physician evaluation and management visits, skilled nursing facility days, drug utilization, and selected clinical indicators. Among the results, the intervention group had considerably and significantly lower rates of acute service utilization compared to the control group, including a 17.5% reduction in hospitalizations, 22.4% reduction in bed days, 12.3% increase in physician evaluation and management visits, 23.7% increase in angiotensin-converting enzyme (ACE) inhibitor use, 13.3% increase in blood glucose regulator use, 11.8% increase in hemoglobin A1c (HbA1c) tests, 10.3% increase in lipid panels, 26.0% increase in eye exams, and 35.5% increase in microalbumin tests. In conclusion, the study demonstrates that a commercially delivered diabetes DM program significantly reduces hospitalizations and bed-days while increasing the use of ACE inhibitors and blood glucose regulators along with selected clinical procedures such as HbA1c tests, lipid panels, eye exams, and microalbumin tests.</p>","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 4","pages":"226-34"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.104704","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26907234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The economic consequences of generic substitution for antiepileptic drugs in a public payer setting: the case of lamotrigine.","authors":"Mei Sheng Duh,&nbsp;Frederick Andermann,&nbsp;Pierre Emmanuel Paradis,&nbsp;Jennifer Weiner,&nbsp;Ranjani Manjunath,&nbsp;Pierre-Yves Crémieux","doi":"10.1089/dis.2007.104649","DOIUrl":"https://doi.org/10.1089/dis.2007.104649","url":null,"abstract":"<p><p>Generic substitution of antiepileptic drugs (AEDs) may increase pharmacy utilization, thus counterbalancing per-pill savings. The purpose of our study was to analyze the economic impact of government-mandated switching from branded to generic lamotrigine. Patients in a Canadian public pharmacy claims database using branded lamotrigine (Lamictal GlaxoSmithKline, UK) in 2002 converted to generic lamotrigine in 2003 and were observed from July 2002 to March 2006. Patients used branded lamotrigine for >or=90 days pre-generic entry and had >or=1 claim for generic lamotrigine post-generic entry. For the generic period, observed per-patient monthly drug costs were calculated as the sum of costs for lamotrigine, other AEDs, and non-AEDs. Expected per-patient drug costs were estimated assuming lamotrigine dose and other prescription drug utilization in the generic period were identical to those observed during the brand period. Differences between observed and expected costs were compared. Among 1,142 branded lamotrigine users, overall average monthly drug costs per person were expected to decrease by $30.55 due to lower pill costs. Instead, they fell by $11.98 from the brand to the generic periods (p < 0.001). Because of dosage changes, lamotrigine costs decreased by $29.92 instead of the anticipated $33.87 (p < 0.001). Increased pharmacy utilization caused other AED costs to rise by $6.29 versus the expected $0.36 (p < 0.001), while non-AED drug cost increased by $11.64 rather than by $2.95 (p < 0.001). We concluded that conversion to generic lamotrigine resulted in lower than expected cost savings. Further research is necessary to determine whether this is due to reduced effectiveness and/or tolerability. Payers may weigh smaller-than-expected cost reductions against a possible decrease in effectiveness to assess the relevance of mandatory generic switching of lamotrigine.</p>","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 4","pages":"216-25"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.104649","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26907233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can disease management transform health care?","authors":"William C Popik","doi":"10.1089/dis.2007.103711","DOIUrl":"https://doi.org/10.1089/dis.2007.103711","url":null,"abstract":"","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 4","pages":"179-84"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.103711","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26905132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating disease management results: individuals and cohorts vs populations.","authors":"Scott Macstravic","doi":"10.1089/dis.2007.103645","DOIUrl":"https://doi.org/10.1089/dis.2007.103645","url":null,"abstract":"","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 4","pages":"185-8"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.103645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26905133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights from the 2007 disease management colloquium.","authors":"David B Nash,&nbsp;Tine Hansen-Turton,&nbsp;Tracey Moorhead,&nbsp;Harry Leider,&nbsp;Donald F Wilson","doi":"10.1089/dis.2007.104724","DOIUrl":"https://doi.org/10.1089/dis.2007.104724","url":null,"abstract":"","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 4","pages":"189-96"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.104724","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26905136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing health information technology to improve the process of health care delivery: a case study.","authors":"Marilyn Follen,&nbsp;Rachel Castaneda,&nbsp;Melissa Mikelson,&nbsp;Debrah Johnson,&nbsp;Alisa Wilson,&nbsp;Keiko Higuchi","doi":"10.1089/dis.2007.104706","DOIUrl":"https://doi.org/10.1089/dis.2007.104706","url":null,"abstract":"<p><p>Integration of health information is critical to the provision of effective, quality care in today's fragmented health care system. The increasing prevalence of chronic conditions and the demand for a comprehensive understanding of patient health on the part of providers are driving the need for the integration of health information through electronic health information systems. Two distinct health information systems currently utilized in the health care field include electronic medical records (EMR) and chronic disease management systems (CDMS). The integration of these systems is likely to enable the efficient management of health information and improve the quality of health care as it would provide real-time patient information in a coordinated manner. The lack of real-time information may result in delayed treatment, uninformed decisions, inefficient resource use, and medical errors. Despite their importance and widespread support, these systems have slow provider adoption rates. Our understanding of how health information technology may be used to improve health care is limited by the relative paucity of research on the adoption, integration, and implementation of these 2 types of systems. This paper documents the use of an EMR at Marshfield Clinic, a multidisciplinary group practice in the United States. We review the concomitant use of an EMR for clinical data capture and the implementation of a proprietary CDMS, InformaCare, for care management of chronic diseases. These 2 systems allow providers to deliver health care using evidence-based guidelines that meet the Institute of Medicine's aim of providing safe, efficient, patient-centered, and timely care.</p>","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 4","pages":"208-15"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.104706","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26907232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paying for disease management.","authors":"Phillip Levy,&nbsp;Robert Nocerini,&nbsp;Kyle Grazier","doi":"10.1089/dis.2007.104646","DOIUrl":"https://doi.org/10.1089/dis.2007.104646","url":null,"abstract":"<p><p>Disease Management (DM) first appeared in the United States in the early 1990s. Since then its incorporation into health plans has increased dramatically, yet proof of its effectiveness in terms of quality improvement and cost reduction remains to be seen. The following review provides an exploratory analysis of the basic principles of DM, its evolution and differences from traditional managed care, the ways in which programs are currently being used in the private and public sectors, and the challenges to determining a payment structure for incorporating DM into the current health insurance system.</p>","PeriodicalId":51235,"journal":{"name":"Disease Management : Dm","volume":"10 4","pages":"235-44"},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/dis.2007.104646","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26907235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}