title: Best practices in innovative type 2 diabetes program management: a case study.
abstract: OBJECTIVE
  To illustrate, through a case study format, a successful type 2 diabetes disease management program.
  
  
  CONCLUSIONS
  Intermountain Health Care (IHC) has implemented an evidence-based, integrated approach to the management of type 2 diabetes that includes multiple interventions: (1) a regularly updated treatment algorithm; (2) a comprehensive data registry to rapidly identify patients with type 2 diabetes; (3) a system of regular patient reminders for laboratory and other relevant testing, such as eye and foot examinations; (4) patient education that fosters an understanding of the benefits of antidiabetic medications and the need for consistent treatment; (5) pharmacist and nurse involvement to facilitate physician appointments when needed, track medication use, ensure consistent compliance, and answer questions; and (6) physician performance reports that provide an opportunity for rapid peer-to-peer outcomes comparisons. The implementation of this program has yielded a substantial increase in the number of patients within the system identified with type 2 diabetes and an increase in the percentage of patients with improved glycemic control based on HbA1c, as well as an unexpected benefit--an increase in the number of patients with improved low-density lipoprotein cholesterol levels.
  
  
  CONCLUSIONS
  An integrated, evidence-based disease management program, such as the one developed by IHC, can improve type 2 diabetes outcomes in the managed care setting and, perhaps, reduce long-term costs.
authors.affiliation: Pharmacy Services and Program Development, Intermountain Health Care, 36 South State St., Suite 1900, Salt Lake City, UT 84111, USA. hpecannon@ihc.com
authors.forename: H Eric
authors.initials: HE
authors.lastname: Cannon
mesh_terms: D000465:Algorithms; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D019468:Disease Management; D019317:Evidence-Based Medicine / Q000458:organization & administration; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008329:Managed Care Programs / Q000458:organization & administration*; D055118:Medication Adherence; D010353:Patient Education as Topic / Q000379:methods; D017410:Practice Guidelines as Topic; D017010:Reminder Systems; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents