TY - JOUR
T1 - Clinical identification and referral of adults with prediabetes to a diabetes prevention program
AU - Holliday, Christopher S.
AU - Williams, Janet
AU - Salcedo, Vanessa
AU - Kandula, Namratha R.
N1 - Funding Information:
At the time of this research, Dr. Kandula and Ms. Salcedo were employed by the American Medical Association. This article is the work of the authors and should not be interpreted as AMA policy. The authors acknowledge Amber L. Ryan, MEd, and Jennifer Briscoe Klein for instrument development. Also, the authors thank Annalynn Skipper, PhD, RD and Sara Alafogianis, MPA, for re- viewing the article. This research project was funded by a grant from the Centers for Medicare and Medicaid Healthcare Innovation Challenge Award (no. 1C1CNS330965-02-00).
Publisher Copyright:
© 2019 Centers for Disease Control and Prevention (CDC).
PY - 2019
Y1 - 2019
N2 - Purpose and Objectives Community programs to prevent or delay the onset of type 2 diabetes are effective, but implementing these programs to maximize their reach and impact remains a challenge. The American Medical Association (AMA) partnered with the YMCA of the USA, as part of a Centers for Medicare and Medicaid Innovation demonstration project, to develop, implement, and evaluate innovative quality improvement strategies to increase routine screening, testing, and referral of Medicare patients with prediabetes to diabetes prevention programs (DPPs) at local YMCAs. Intervention Approach AMA recruited 26 primary care practices and health systems in 17 US communities to implement point-of-care and retrospective methods (or a combination of both) for screening, testing, and referral of Medicare patients with prediabetes. Evaluation Methods We assessed changes in rates of referral and enrollment of patients among participating practices. We used a mixed-methods pretest-posttest evaluation design to determine if use of certain tools and resources, coupled with systems changes, led to increased screening and referrals. Results Practices referred a total of 5,640 patients, of whom 1,050 enrolled in a YMCA DPP (19%; range, 2%-98%). Practices (n = 12) that used retrospective (ie, electronic medical record [EMR]) systems to identify eligible Medicare patients via a registry referred more people (n = 4,601) to the YMCA DPP than practices (n = 10) that used a point-of-care method alone (n = 437 patients) or practices (n = 4) that used a combination of these approaches (n = 602 patients). All approaches showed increased enrollment with pointof- care methods being most successful. Implications for Public Health Lessons learned from this intervention can be used to increase diabetes prevention in the United States and support the Centers for Medicare and Medicaid Services (CMS) decision to expand Medicare coverage to include the DPP for all Medicare beneficiaries.
AB - Purpose and Objectives Community programs to prevent or delay the onset of type 2 diabetes are effective, but implementing these programs to maximize their reach and impact remains a challenge. The American Medical Association (AMA) partnered with the YMCA of the USA, as part of a Centers for Medicare and Medicaid Innovation demonstration project, to develop, implement, and evaluate innovative quality improvement strategies to increase routine screening, testing, and referral of Medicare patients with prediabetes to diabetes prevention programs (DPPs) at local YMCAs. Intervention Approach AMA recruited 26 primary care practices and health systems in 17 US communities to implement point-of-care and retrospective methods (or a combination of both) for screening, testing, and referral of Medicare patients with prediabetes. Evaluation Methods We assessed changes in rates of referral and enrollment of patients among participating practices. We used a mixed-methods pretest-posttest evaluation design to determine if use of certain tools and resources, coupled with systems changes, led to increased screening and referrals. Results Practices referred a total of 5,640 patients, of whom 1,050 enrolled in a YMCA DPP (19%; range, 2%-98%). Practices (n = 12) that used retrospective (ie, electronic medical record [EMR]) systems to identify eligible Medicare patients via a registry referred more people (n = 4,601) to the YMCA DPP than practices (n = 10) that used a point-of-care method alone (n = 437 patients) or practices (n = 4) that used a combination of these approaches (n = 602 patients). All approaches showed increased enrollment with pointof- care methods being most successful. Implications for Public Health Lessons learned from this intervention can be used to increase diabetes prevention in the United States and support the Centers for Medicare and Medicaid Services (CMS) decision to expand Medicare coverage to include the DPP for all Medicare beneficiaries.
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U2 - 10.5888/pcd16.180540
DO - 10.5888/pcd16.180540
M3 - Article
C2 - 31255186
AN - SCOPUS:85068221841
SN - 1545-1151
VL - 16
JO - Preventing Chronic Disease
JF - Preventing Chronic Disease
IS - 6
M1 - 180540
ER -
