Quality

Disease management programs are associated with higher levels of diabetes monitoring among patients, but such programs do not appear to improve intermediate outcomes -- such as hemoglobin levels, blood pressure and cholesterol levels -- according to a study published in the Annals of Internal Medicine.

The study involved 8,661 diabetic patients and 63 health care provider groups using three disease management strategies:

Provider feedback;
Reminders; and
Structured care.

To determine the effectiveness of different disease management programs, researchers measured eight factors, including:

Most recent hemoglobin level;
Systolic blood pressure;
LDL cholesterol level; and
Several measures of medication use.

The authors found that increasing the use of any of the three disease management strategies led to improved diabetes care but that no strategies were associated with better intermediate outcome levels or increased use of diabetes medication.

Researchers recommend that disease management programs focus more on direct measurement of and feedback about intermediate outcomes, as well as measurements of clinical processes of care that have more direct links to improved patient outcomes. Reporting such intermediate outcomes or levels of medication management also might improve disease management programs for diabetics, the authors concluded (Mangione et al., Annals of Internal Medicine, 7/18). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.