title: Impact of telephonic interventions on glycosylated hemoglobin and low-density lipoprotein cholesterol testing.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Retrospective, observational cohort study before and after DM program implementation.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Telephonic interventions as part of comprehensive DM programs are associated with improved disease-monitoring testing.
authors.affiliation: Healthways, Inc., Nashville, TN, USA. carter.coberley@healthways.com
authors.forename: Carter
authors.initials: C
authors.lastname: Coberley
authors.forename: Brent
authors.initials: B
authors.lastname: Hamar
authors.forename: Bill
authors.initials: B
authors.lastname: Gandy
authors.forename: Patty
authors.initials: P
authors.lastname: Orr
authors.forename: Sadie
authors.initials: S
authors.lastname: Coberley
authors.forename: Matthew
authors.initials: M
authors.lastname: McGinnis
authors.forename: Laurel
authors.initials: L
authors.lastname: Hudson
authors.forename: Sam
authors.initials: S
authors.lastname: Forman
authors.forename: Dexter
authors.initials: D
authors.lastname: Shurney
authors.forename: James
authors.initials: J
authors.lastname: Pope
mesh_terms: D000328:Adult; D000368:Aged; D008078:Cholesterol, LDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013689:Telephone
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin