Strategies to Help People with Type 2 Diabetes Start and Stick to Their Diabetes Medications

Size: px
Start display at page:

Download "Strategies to Help People with Type 2 Diabetes Start and Stick to Their Diabetes Medications"

Transcription

1 Strategies to Help People with Type 2 Diabetes Start and Stick to Their Diabetes Medications

2 Credentials: BSN Clinical Health Coach Certified Application Counselor (Current student:msn-informatics) Work Setting: Linn County Public Health Contact:

3 Credentials: Masters of Nursing in Health Advocacy Certified Medical Surgical Registered Nurse Certified Diabetes Educator Contact: Work Setting: UnityPoint Health (Cedar Rapids, Iowa): Combined Inpatient Glycemic Management and Outpatient Educator Non-UnityPoint Affiliated: Type2andYou.org Type2andYou with Meg (a diabetes podcast)

4 Megan Muñoz Self-Managed Stockholder in Tandem and Dexcom Cindy Fiester None

5 Identify the depth of the medication adherence problem in T2D Identify barriers to med adherence in T2D Identify at least two techniques that can be applied to practice to improve medication adherence Identify at least one resource that can impact medication adherence outcomes

6 Cost is a major, recognized barrier for medication adherence for patients. However, this presentation is focused on adherence techniques assuming cost has been addressed.

7 I knowwww it s hard after lunch!

8 American Diabetes Association (2019). Overcoming Therapeutic Inertia: Summary of Proceedings. Retrieved from Edelman, Steven V. and Polonsky, William H. Type 2 Diabetes in the Real World: The Elusive Nature of Glycemic Control. Diabetes Care 2017 Nov; 40(11):

9

10 Nelson, L. A., Wallston, K. A., Kripalani, S., LeStourgeon, L. M., Williamson, S. E., & Mayberry, L. S. (2018). Assessing barriers to diabetes medication adherence using the Information-Motivation-Behavioral skills model. Diabetes research and clinical practice, 142, doi: /j.diabres Brown, M. T., & Bussell, J. K. (2011). Medication adherence: WHO cares?. Mayo Clinic proceedings, 86(4), doi: /mcp Most Common Patient Reported Barriers: Diabetes Burnout Forgetting Medication Doses Not Seeing Immediate Benefit in Blood Sugars Brand Name is Perceived as More Effective than Generic Concern for side effects

11 Medication Management and Safety Assessments Linn County State Innovation Model Grant

12 Number of Respondents = 57 Hospital (n = 30), Primary Care Clinic (n = 19), FQHC (n = 18), Public Health, Free Clinic, Diabetes Center, Specialty Clinic, Pharmacy Provider, Nurse, Care Coordinator, Educator or Health Coach, Pharmacist/Resident, Social Worker, CEO, Clinical Manager

13 A majority of participants (87.7%) state that their organization does provide medication education Most commonly believed to be provided by provider, nurse, or pharmacist. However, no clear staff role responsible or protocol established for providing education Typically 2-5 minutes is spent on education. Time constraint played a significant role for 59.7% of respondents Teach-back was the most common strategy for ensuring patient understanding (64.9%) 75% of Providers note that they Always or Usually use teach-back

14 30% 28% 25% 23% 20% 19% 15% 14% 12% 10% 5% 4% 0% Very Good Good Acceptable Poor Very Poor Does Not Apply

15 A majority of respondents state that their organization does not have a protocol or process in place to confirm medication adherence (52.6%); an additional 19.3% of respondents were not sure if their organization had a protocol in place. Personal processes Ask at appointment (56.9%) Pharmacy Verification (39.2%) Involve other members of care team (11.8%) Discuss barriers with individual (9.8%) Contact patient (9.8%)

16 Automatic refills 29.2% Private Counseling 25.0% Med Pack programs 20.8% Medication Delivery 12.5% Med Syn programs 12.5% 0% 5% 10% 15% 20% 25% 30% 35%

17 A majority of respondents (77.8%) state that they regularly ask patients about external barriers to taking their medications. Care Coordinator, Social Worker, Health Coach: 87.5% Providers: 82.1% Nurses: 66.7%

18 SOCIAL DETERMINANTS Cost (n = 41; 75.9%) Uninsured/Underinsured Lack of Available Finances Competing Priorities Social Stressors Basic Needs (ex: Housing, food, bills) Transportation EIHC and Hospital patients particularly OTHER Misunderstanding (n = 23; 42.6%) When to start meds How often meds need to be taken Purpose and importance of taking meds Possible side effects Lack of Motivation Forget to take medications

19 ANCILLARY REFERRALS Process for referral differed between organizations and at times respondents in same organization Respondents associated with EIHC were most likely to agree on a specific process for referral; including staff responsible for handling TRIGGER TO DIABETES EDUCATION New Diagnosis A1C Lack of Engagement/Compliance Change in health status Lack of Achievement Does not apply Patient Requests Referral Physician Discretion 8.8% 7.0% 7.0% 3.5% 61.4% 56.1% 75.4% 84.2% 0% 20% 40% 60% 80% 100%

20 Identify staff person responsible for providing medication education Educate staff on agency practices and protocols Formalize and improve the process for, Providing medication education Tracking and identifying medication adherence Referring patients to external resources including diabetes education Communicating patient information between discharging hospital and clinics (particularly for those without interfacing software)

21 March 2018

22 Routine and Organization Helpful Opportunity: Med Pack program Misunderstanding of Medications Side Effects* Dosage* Timing* Storage Importance and purpose* Stop when feel better* Change dose when feel needed* Communication Poor or no instruction on taking med. Providers do not listen Providers and clinics do not communicate with one another Medication changes not communicated following discharge Inaccurate medication list at different providers

23 Medication Barriers Cost* Transportation* Rural locale Physical Limitations Pharmacy Refills delayed Different refill schedules Opportunity: Med Sync and Medication Delivery Programs Price differences between pharmacies Care Coordination Care coordinator or advocate assists with barriers, improving medication understanding and adherence Want care coordination system

24 We get it, Megan and Cindy.it s a problem. But what do we do??

25 Help Decrease the Diabetes Self-Care Burden PWD is ABLE to Make an Informed Decision vs an Emotional Decision PWD Feels of Equal Importance on Their Healthcare Team

26 Trialing Interventions Changing the Narrative Understanding PWD Perspectives

27 NO ONE says Sign me up for a new kidney and a fake leg.

28

29

30 Cost Potential SE Timing

31 He got off all meds. But it s not working for me. What am I doing wrong?? She takes insulin. She should ve taken better care of herself. I would never let myself get that bad.

32 PWD-Perceived Success Weight loss Little to no need for medication Any medication use other than insulin Science-Based Reality Sustained weight loss near 2-5% success rate Only about 15% manage diabetes w/o medication Healthy BG, BP, and Cholesterol lead to great outcomes regardless of medication type or body size CDC. (

33 Our Language Has Lasting Impacts

34 We Don t Give Credit Where Credit is Due Pulmonary HTN Using Regular Insulin OTC Distrust of Medical Pick System Up Insulin From Pharmacy Asked to Quit Work Pay out of Pocket for Forced Insulinto Move in With Mom Take Time to Take Insulin Shame Doses and Guilt around using Check Glucose Levels state-funded Life expectancy assistance 6 months-1 year Continue Despite the Hasn t Negative seen PCP Impacts of Hypoglycemia Regular for 10+ years Hypoglycemia Cardiomyopathy

35 Trialing Interventions Changing the Narrative Understanding PWD Perspectives

36 We are their healthcare team. They are not our patient.

37 empathy is of unquestionable importance No thank you put those glasses back up and pat my back! Affective empathy and partnership have the two largest impacts on patient adherence. Ranking higher even than expertise. Kim, S. S., Kaplowitz, S., & Johnston, M. V. (2004). The Effects of Physician Empathy on Patient Satisfaction and Compliance. Evaluation & the Health Professions, 27(3),

38 How well do you think your diabetes plan is working? Tell me your biggest concern about your diabetes plan right now. LISTENING IS KEY Have you had to stop your medications for any reason? Many people struggle with taking their medications, how often do you miss doses? Are you noticing side effects of your medications?

39 Roadblocks/Resistance

40 Refuse initiation of insulin or other new medications Can t take more than X units of insulin without having a low blood sugar Going to start lifestyle changes soon aka a diet program next month, gym next week, etc. Want to try lifestyle changes for longer before meds Don t feel any different (not checking glucose) know how their body feels with blood sugars and it feels fine Diabetes denial Diabetes burnout

41 I know you d like to wait on medications until you start your weight loss program next month, but your blood sugars are too unhealthy to wait. We can always decrease or stop medications as your body changes. Your A1c is at an unhealthy level. I d like to talk through some options on how we can start getting your blood sugar into healthier ranges. Your body isn t the same at 60 as it is at 20, so it would be unrealistic if we expected your diabetes needs to stay the same too.

42 Trialing Interventions Changing the Narrative Understanding PWD Perspectives

43 1. Demonstrate a Need/Make It Visible 2. Maximize Current Regimen 3. Explore New Med Options Together 4. Trialing Technique 5. Maximize Glucose Checking 6. DSMT

44 Review their medical evidence WITH them: Blood glucose logs Labs BP A1c trends Kidney function Cholesterol Link reported med adherence to outcomes (without shaming them) Their medical evidence is used to reinforce their view that plan is working OR help them identify a need for new one The Metformin Struggle

45 How much could you impact someone s A1C level by showing them their lab result and discussing it with them? Chapin, R. B., Williams, D. C., & Adair, R. F. (2003). Diabetes control improved when inner-city patients received graphic feedback about glycosylated hemoglobin levels. Journal of general internal medicine, 18(2), doi: /j x

46 Extended Release/Long Half-Life Meds-20-30% Combination Meds-26% Medication Pocketcards (FREE): ket-cards-insulin-anddiabetes-medication/ Extend this to HTN 000/0515/p3049.html Co-pay Cards, Prescription Ass. Programs Blister Packaging 90 Day Supply Brown, M. T., & Bussell, J. K. (2011). Medication adherence: WHO cares?. Mayo Clinic proceedings, 86(4), doi: /mcp Kripalani S, Yao X, Haynes RB. Interventions to Enhance Medication Adherence in Chronic Medical Conditions: A Systematic Review. Arch Intern Med. 2007;167(6): doi: /archinte

47 Current Regimen: Glimepiride 2 mg/daily Metformin 1000 mg BID Victoza 1.2 mg/day Tresiba 18 units/day New Regimen: Metformin ER 2000 mg daily GLP-1/Insulin Combo (Xultophy or Soliqua)

48 Explore New Medication Options Together

49 What does the conversation look like? Other health conditions (cardiac, renal, diabetes complications) Age/#of Meds/Length of Time You ve Had Diabetes A1c Use Medication Sheets and/or Discuss Risk/Benefits of Top 2 Verify insurance coverage/cost of the top 2 patient & provider preferred choices

50 1. The Trialing Technique 1. Maximize Glucose Checking 2. Follow-Up/Review Patient-Gathered Evidence 2. Diabetes Self-Management Training

51 It s Working SMARTER Not HARDER

52 Trialing is effective because it turns: Long-term into short-term Allows for medication or lifestyle failure without guilt Sets up opportunity for patient-identified success Gives PWD room to move through guilt, fear, uncertainty Allows you to troubleshoot any barriers to adherence (cost, pain on injection, s/e) Sets realistic expectations

53 Ask if they d be willing to trial the medication for X amount of time and come back to see you. The Good The Bad

54 Discuss important aspects: How to use and store medication Potential side effects/benefits When to expect blood sugars to be impacted (Use Medication Sheet here or any visual/discussion that helps them better understand what to expect)

55 Glucose Checking Have them check glucose at times blood sugar will be most impacted TIP: Have them check at times blood sugars will be mostly affected for three days without meds and then do it three days when med has taken near-max effect

56 Example A: Traditional Fasting Post Breakfast Pre Lunch Example B: Targeted Pre Supper Bedtime Fasting Post Breakfast Pre Lunch Pre Supper Bedtime

57 MOST people will come back with improved glucose levels or improved level of engagement when doing this form of checking MOST people will extend the med adherence behavior into other times of the day Can be applied to ANY self-care behavior

58 Create a Follow Up Plan Bring back their gathered evidence Schedule when medication will be effective

59 Stay True to Your Word: Good, Bad, and What do you think? How did it go? What worked, what didn t work? Reinforce positive behaviors and support making invisible -----VISIBLE (use patientgathered data) Intervene on barriers to continued use of medication--dsmt

60 Is A Process NOT an Event POOF!

61 The things they feared are not so bad (ex: an injection) Benefit outweighs the burden They can finally reduce stress about blood sugars (they see healthier ones!) Improved quality of life Less burnout More likely to be active in their other diabetes cares

62 What if PWD always wants to put off med start until next visit because they want to continue working on diet and exercise? Can t take more than x units at meal?

63 What If They Come Back and Still Say NO!

64 Realistic expectations (75% in range) remove perfection expectations Risk vs benefit (not maximizing cost of med etc) Dosing rapid with largest meal only Dexcom G6 alarms

65

66

67 2018 by American Diabetes Association Melanie J. Davies et al. Dia Care 2018;41:

68 Improved BP and lipids Lower BMI Improvements in depression Lowers A1c 1-2% Reduced Healthcare costs Reduced Hospitalizations/ ER visits More likely to meet self-care goals

69

70 2018 by American Diabetes Association Melanie J. Davies et al. Dia Care 2018;41:

71 Medication Makeovers At minimum on an annual basis, or anytime a new med is added, review meds to see if any: -can be combined together -can be switched to extended release -can be timed differently to reduce the number of times a day they need to be taken -can be reduced or stopped -interact with one another -are available in generic versions -if the brand name medications have a copay card (discount card) that can be applied

A Simplified Approach to Initiating Insulin. 4. Not meeting glycemic goals with oral hypoglycemic agents or

A Simplified Approach to Initiating Insulin. 4. Not meeting glycemic goals with oral hypoglycemic agents or A Simplified Approach to Initiating Insulin When to Start Insulin: 1. Fasting plasma glucose (FPG) levels >250 mg/dl or 2. Glycated hemoglobin (A1C) >10% or 3. Random plasma glucose consistently >300 mg/dl

More information

Challenges in Glycemic Control in Adult and Geriatric Patients. Denyse Gallagher, APRN-BC, CDE Endocrinology Nurse Practitioner

Challenges in Glycemic Control in Adult and Geriatric Patients. Denyse Gallagher, APRN-BC, CDE Endocrinology Nurse Practitioner Challenges in Glycemic Control in Adult and Geriatric Patients Denyse Gallagher, APRN-BC, CDE Endocrinology Nurse Practitioner Provide an overview of diabetes prevalence; discuss challenges and barriers

More information

Hypertension Best Practices Symposium

Hypertension Best Practices Symposium essentia health: east region 1 Hypertension Best Practices Symposium RN Hypertension Management Pilot Essentia Health: East Region Duluth, MN ORGANIZATION PROFILE Essentia Health is an integrated health

More information

Pharmacy and the Medicaid Accountable Care Organization

Pharmacy and the Medicaid Accountable Care Organization RCCO Pilot Project CDC Grant Increase engagement of non-physician team members (ie., pharmacists) in Hypertension (HTN) and Diabetes Mellitus (DM) management in health care systems; Increase the proportion

More information

Chapter 1 The Importance of Education in Diabetes

Chapter 1 The Importance of Education in Diabetes Chapter 1 The Importance of Education in Diabetes H. Peter Chase, MD DeAnn Johnson, RN, BSN, CDE INTRODUCTION Families and children need to understand as much as possible about diabetes. A shorter book,

More information

6. MEASURING EFFECTS OVERVIEW CHOOSE APPROPRIATE METRICS

6. MEASURING EFFECTS OVERVIEW CHOOSE APPROPRIATE METRICS 45 6. MEASURING EFFECTS OVERVIEW In Section 4, we provided an overview of how to select metrics for monitoring implementation progress. This section provides additional detail on metric selection and offers

More information

Managing the Diabetes Patient. Dan Kremer, RN, BSN Diabetes Nurse Educator

Managing the Diabetes Patient. Dan Kremer, RN, BSN Diabetes Nurse Educator Managing the Diabetes Patient Dan Kremer, RN, BSN Diabetes Nurse Educator Objectives Referring & assessing the inpatient Address the needed diabetes education for the patients survival skills Problem solving

More information

Special Considerations

Special Considerations Special Considerations Women and cart to Treatment What is medication adherence? taking medication exactly the way it is prescribed by the doctor taking the right amount of medication at the right time

More information

HEALTH INSURANCE EMPLOYEE EDUCATION: PREVENTIVE CARE

HEALTH INSURANCE EMPLOYEE EDUCATION: PREVENTIVE CARE HEALTH INSURANCE EMPLOYEE EDUCATION: PREVENTIVE CARE Mott Community College Health Benefits Task Force DISCLAIMER The content in this presentation is informational. Each employee should review the benefit

More information

Tips To Improve 5-Star Performance Ratings

Tips To Improve 5-Star Performance Ratings Tips To Improve 5-Star Performance Ratings Two different patient surveys impact CMS Star ratings: 1. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, typically mailed to plan

More information

Overview. Provider Qualifications

Overview. Provider Qualifications Overview Diabetes self management training (DSMT) is a collaborative process through which patients with diabetes gain knowledge and skills needed to modify behavior and successfully manage the disease

More information

type 2 diabetes and you Live Well with Diabetes

type 2 diabetes and you Live Well with Diabetes type 2 diabetes and you Live Well with Diabetes Basic Guidelines for Good Diabetes Care Check your blood sugar regularly At every doctor visit: Review your blood sugar records Blood pressure Weight Foot

More information

British Columbia Pharmacy Association (BCPhA) Clinical Service Proposal Self-Monitoring of Blood Glucose in Type 2 Diabetes

British Columbia Pharmacy Association (BCPhA) Clinical Service Proposal Self-Monitoring of Blood Glucose in Type 2 Diabetes British Columbia Pharmacy Association (BCPhA) Clinical Service Proposal Self-Monitoring of Blood Glucose in Type 2 Diabetes Introduction Self-monitoring of blood glucose (SMBG) is in widespread use among

More information

Inpatient Treatment of Diabetes

Inpatient Treatment of Diabetes Inpatient Treatment of Diabetes Alan J. Conrad, MD Medical Director Diabetes Services EVP, Physician Alignment Diabetes Symposium November 12, 2015 Objectives Explain Palomar Health goals for inpatient

More information

ACTIVELY MANAGED DRUG SOLUTIONS. for maintenance and specialty medication. Actively Managed Drug Solutions is not available in the province of Quebec

ACTIVELY MANAGED DRUG SOLUTIONS. for maintenance and specialty medication. Actively Managed Drug Solutions is not available in the province of Quebec ACTIVELY MANAGED DRUG SOLUTIONS for maintenance and specialty medication Actively Managed Drug Solutions is not available in the province of Quebec ARE YOU UNDERESTIMATING THE IMPACT OF CHRONIC DISEASE?

More information

Delta s Healthy Rewards Program. Administration Services

Delta s Healthy Rewards Program. Administration Services Delta s Healthy Rewards Program Administration Services Helping You Navigate the Winding Road of Healthcare Reform The crisis is real. Chronic diseases, such as diabetes and heart disease, are steering

More information

Medical Regimen Adherence in the Management of Diabetes: What Psychologists Need to Know

Medical Regimen Adherence in the Management of Diabetes: What Psychologists Need to Know Medical Regimen Adherence in the Management of Diabetes: What Psychologists Need to Know Suzanne Bennett Johnson Distinguished Research Professor Florida State University College of Medicine 2012 President,

More information

Intake / Admissions Processes

Intake / Admissions Processes Intake / Admissions Processes Now that the elements of providing quality customer service have been reviewed, the intake and admission processes will be covered. Some homecare companies make a distinction

More information

INPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco

INPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco INPATIENT DIABETES MANAGEMENT Robert J. Rushakoff, MD Professor of Medicine Director, Inpatient Diabetes University of California, San Francisco CLINICAL RECOGNITION Background: Appropriate inpatient glycemic

More information

2016 PHARMACY. Benefit Summary Book. RXSUMBK2016 www.fepblue.org

2016 PHARMACY. Benefit Summary Book. RXSUMBK2016 www.fepblue.org 2016 Benefit Summary Book RXSUMBK2016 www.fepblue.org REVIEW THIS SUMMARY BOOKLET TO LEARN HOW TO GET THE MOST FROM YOUR PRESCRIPTION BENEFIT. THIS INCLUDES INFORMATION ABOUT: n Your prescription drug

More information

The Teach Back Technique

The Teach Back Technique The Teach Back Technique Communicating Effectively With Patients Table of Contents What Is the Teach Back Technique?...2 Why Use the Teach Back Technique?...2 Teach Back Tips and Cautions...4 Tips...4

More information

The Role of the Certified Diabetes Educator: A Team Effort

The Role of the Certified Diabetes Educator: A Team Effort Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/diabetes-discourse/role-certified-diabetes-educator-team-effort/7587/

More information

Algorithms for Glycemic Management of Type 2 Diabetes

Algorithms for Glycemic Management of Type 2 Diabetes KENTUCKY DIABETES NETWORK, INC. Algorithms for Glycemic Management of Type 2 Diabetes The Diabetes Care Algorithms for Type 2 Diabetes included within this document are taken from the American Association

More information

Desktop Guidelines for Insulin Adjustment

Desktop Guidelines for Insulin Adjustment Desktop Guidelines for Insulin Adjustment Disclaimer and terms of use: This document and workshop (the Material ) has been prepared for informational and training purposes for employees of the Endocrinology

More information

Population Health Management Program

Population Health Management Program Population Health Management Program Program (formerly Disease Management) is dedicated to improving our members health and quality of life. Our Population Health Management Programs aim to improve care

More information

An Introduction to Medication Adherence

An Introduction to Medication Adherence An Introduction to Medication Adherence Medication Adherence Project (MAP) A project of the Cardiovascular Prevention & Control Program and the Fund for Public Health in New York Drugs don t work in patients

More information

10/31/2014. Medication Adherence: Development of an EMR tool to monitor oral medication compliance. Conflict of Interest Disclosures.

10/31/2014. Medication Adherence: Development of an EMR tool to monitor oral medication compliance. Conflict of Interest Disclosures. Medication Adherence: Development of an EMR tool to monitor oral medication compliance Donna Williams, RN PHN Carol Bell, NP MSN Andrea Linder, RN MS CCRC Clinical Research Nurses Stanford University SOM

More information

Health System Strategies to Improve Chronic Disease Management and Prevention: What Works?

Health System Strategies to Improve Chronic Disease Management and Prevention: What Works? Health System Strategies to Improve Chronic Disease Management and Prevention: What Works? Michele Heisler, MD, MPA VA Center for Clinical Practice Management Research University of Michigan Department

More information

How to Increase Value on Investment for Your Wellness Program

How to Increase Value on Investment for Your Wellness Program How to Increase Value on Investment for Your Wellness Program A Real World Case Study 2016 Health Designs. All rights reserved. Introduction Onsite Intrinsic Coaching Improves Health, Well-Being and Job

More information

What do you know about HbA1C

What do you know about HbA1C Did you know? Essential advice for people with diabetes from Accu-Chek HbA1C is a measure of your average blood glucose level over 3 months Your HbA1C target should be under 53mmol/mol It is important

More information

A Guide to Patient Services. Cedars-Sinai Health Associates

A Guide to Patient Services. Cedars-Sinai Health Associates A Guide to Patient Services Cedars-Sinai Health Associates Welcome Welcome to Cedars-Sinai Health Associates. We appreciate the trust you have placed in us by joining our dedicated network of independent-practice

More information

Diabetes and Blood Pressure PIP Care Coordinator Toolkit. Provided by: - 1 -

Diabetes and Blood Pressure PIP Care Coordinator Toolkit. Provided by: - 1 - Diabetes and Blood Pressure PIP Care Coordinator Toolkit Provided by: - 1 - Project Summary MSHO/MSC+/SNBC Community & Institutionalized Blood Pressure Control for Members with Diabetes 2010 Performance

More information

Gestational diabetes. Information to help you stay healthy during your pregnancy. What is gestational diabetes?

Gestational diabetes. Information to help you stay healthy during your pregnancy. What is gestational diabetes? Gestational diabetes Information to help you stay healthy during your pregnancy What is gestational diabetes? How gestational diabetes can affect my baby How to take care of myself and my baby during pregnancy

More information

Workshop on Patient Support and Market Research Programmes

Workshop on Patient Support and Market Research Programmes Workshop on Patient Support and Market Research Programmes Spectrum of programmes falling under the terms of PSP and MRPs and the and the type of safety data collected Pharmaceutical Industry Associations

More information

Let s Talk About Meters and Meds. Adapted for Upstate Medical University by: Kristi Shaver, BS, RN, CDE, MS-CNS Student (2014) January 2014

Let s Talk About Meters and Meds. Adapted for Upstate Medical University by: Kristi Shaver, BS, RN, CDE, MS-CNS Student (2014) January 2014 Let s Talk About Meters and Meds Adapted for Upstate Medical University by: Kristi Shaver, BS, RN, CDE, MS-CNS Student (2014) January 2014 How to monitor diabetes control: Hemoglobin A 1 C, or just A 1

More information

New Beginnings: Managing the Emotional Impact of Diabetes Module 1

New Beginnings: Managing the Emotional Impact of Diabetes Module 1 New Beginnings: Managing the Emotional Impact of Diabetes Module 1 ALEXIS (AW): Welcome to New Beginnings: Managing the Emotional Impact of Diabetes. MICHELLE (MOG): And I m Dr. Michelle Owens-Gary. AW:

More information

Self-Monitoring of Blood Glucose

Self-Monitoring of Blood Glucose My Doctor Says I Should Monitor My Blood Glucose... What Does This Mean? BD Getting Started Self-Monitoring of Blood Glucose Daily Blood Sugar Monitoring When you have diabetes, managing your blood glucose

More information

BACKGROUND. ADA and the European Association recently issued a consensus algorithm for management of type 2 diabetes

BACKGROUND. ADA and the European Association recently issued a consensus algorithm for management of type 2 diabetes BACKGROUND More than 25% of people with diabetes take insulin ADA and the European Association recently issued a consensus algorithm for management of type 2 diabetes Insulin identified as the most effective

More information

My Doctor Says Stress is Bad for My Diabetes... What Can I Do About It? BD Getting Started. Stress and Diabetes

My Doctor Says Stress is Bad for My Diabetes... What Can I Do About It? BD Getting Started. Stress and Diabetes My Doctor Says Stress is Bad for My Diabetes... What Can I Do About It? BD Getting Started Stress and Diabetes Doesn t Everyone Have Stress? It s true that stress is part of everyday life for everyone.

More information

Affordable Effective Comprehensive Integrated

Affordable Effective Comprehensive Integrated Affordable Effective Comprehensive Integrated Why The Bridge? One of the most difficult challenges currently facing the medical community is the ill or injured individual who does not fully recover despite

More information

An Overview of Medicare Covered Diabetes Supplies and Services

An Overview of Medicare Covered Diabetes Supplies and Services News Flash - Understanding the Remittance Advice: A Guide for Medicare Providers, Physicians, Suppliers, and Billers serves as a resource on how to read and understand a Remittance Advice (RA). Inside

More information

FORWARDHEALTH PRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL) FOR HYPOGLYCEMICS, INSULIN LONG-ACTING

FORWARDHEALTH PRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL) FOR HYPOGLYCEMICS, INSULIN LONG-ACTING DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN Division of Health Care Access and Accountability Wis. Admin. Code DHS 107.10(2) FORWARDHEALTH PRIOR AUTHORIZATION / PREFERRED DRUG LIST (PA/PDL) FOR HYPOGLYCEMICS,

More information

Prescription Drug Plan

Prescription Drug Plan Prescription Drug Plan The prescription drug plan helps you pay for prescribed medications using either a retail pharmacy or the mail order program. For More Information Administrative details and procedures

More information

Resident s Guide to Inpatient Diabetes

Resident s Guide to Inpatient Diabetes Resident s Guide to Inpatient Diabetes 1. All patients with diabetes of ANY TYPE, regardless of reason for admission, must have a Hemoglobin A1C documented in the medical record within 24 hours of admission

More information

Using the Concept of Being Safe as a Positive Motivator In Diabetes Education

Using the Concept of Being Safe as a Positive Motivator In Diabetes Education Inova Health System Using the Concept of Being Safe as a Positive Motivator In Diabetes Education Ann Carnes MN RN CDE Sally Guise RD CDE AADE Annual Meeting August 6, 2009 Why Safety? 67% of Americans

More information

Diabetes means you have too much sugar in

Diabetes means you have too much sugar in WHAT IS DIABETES? Diabetes means you have too much sugar in your blood. The medical word for sugar in the blood or blood sugar is glucose, but most people just say sugar. Your body changes most of the

More information

Management of Diabetes in the Elderly. Sylvia Shamanna Internal Medicine (R1)

Management of Diabetes in the Elderly. Sylvia Shamanna Internal Medicine (R1) Management of Diabetes in the Elderly Sylvia Shamanna Internal Medicine (R1) Case 74 year old female with frontal temporal lobe dementia admitted for prolonged delirium and frequent falls (usually in the

More information

The Patient-Centered Medical Home How Does Managed Care Pharmacy Add Value?

The Patient-Centered Medical Home How Does Managed Care Pharmacy Add Value? The Patient-Centered Medical Home How Does Managed Care Pharmacy Add Value? With heath care reform now being implemented, it is important that managed care pharmacy understand how to provide value for

More information

An Overview and Guide to Healthy Living with Type 2 Diabetes

An Overview and Guide to Healthy Living with Type 2 Diabetes MEETING YOUR GOALS An Overview and Guide to Healthy Living with Type 2 Diabetes MEETING YOUR GOALS This brochure was designed to help you understand the health goals to live a healthy lifestyle with type

More information

CIGNA Small Group Business

CIGNA Small Group Business HEALTH BENEFIT SOLUTIONS 806774 11/06 CIGNA HEALTHCARE. PROTECTING THE HEALTH OF SMALL GROUPS IN A BIG WAY. Business owners with 50 or fewer employees face a big decision. How can they provide their employees

More information

Managing Patients with Multiple Chronic Conditions

Managing Patients with Multiple Chronic Conditions Best Practices Managing Patients with Multiple Chronic Conditions Advocate Medical Group Case Study Organization Profile Advocate Medical Group is part of Advocate Health Care, a large, integrated, not-for-profit

More information

12/2/2011. Optimal Rehabilitation of the Cardiac Patient with Diabetes. Barbara Masters, BSN, RN-BC. Memorial Hospital Services.

12/2/2011. Optimal Rehabilitation of the Cardiac Patient with Diabetes. Barbara Masters, BSN, RN-BC. Memorial Hospital Services. Optimal Rehabilitation of the Cardiac Patient with Diabetes Barbara Masters, BSN, RN-BC Memorial Hospital Services Magnet accredited hospital April 2008 Acute Care Facility 316 Licensed beds Certified

More information

Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases

Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Epidemiology Over 145 million people ( nearly half the population) - suffer from asthma, depression and other chronic

More information

Connect4 Patients CCCM Primary Care Community. Presented By: Veronica Mansfield, DNP, APRN, AE-C, CCM Kit McKinnon, MBA, BSN, RN, CDE, CCM

Connect4 Patients CCCM Primary Care Community. Presented By: Veronica Mansfield, DNP, APRN, AE-C, CCM Kit McKinnon, MBA, BSN, RN, CDE, CCM Connect4 Patients CCCM Primary Care Community Presented By: Veronica Mansfield, DNP, APRN, AE-C, CCM Kit McKinnon, MBA, BSN, RN, CDE, CCM September 17, 2015 Objectives: Describe innovative care management

More information

Diabetes and Emotions

Diabetes and Emotions monitor track manage A TRUEinsight Guide manage Diabetes and Emotions Understanding and Coping With the Emotional Aspects of Diabetes The importance of understanding your emotions A TRUEinsight Guide about

More information

Hello. Medicare Advantage plans. Overview 2. Plans 3. Timing 6. Tools 7

Hello. Medicare Advantage plans. Overview 2. Plans 3. Timing 6. Tools 7 Hello Advantage At UnitedHealthcare, we want you to get the most from your Medicare coverage. Our simple, all-in-one Medicare Advantage plans are designed to offer you benefits, services and tools to help

More information

Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Health Corporation, a Mutual Legal Reserve Company, an Independent Licensee

Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Health Corporation, a Mutual Legal Reserve Company, an Independent Licensee Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Health Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. 012

More information

WEIGHT MANAGEMENT PROGRAMS & RESOURCES

WEIGHT MANAGEMENT PROGRAMS & RESOURCES WEIGHT MANAGEMENT PROGRAMS & RESOURCES At Tufts Health Plan, we know it s important to help our members achieve and maintain a healthy weight. Being at a healthy weight can improve your health and reduce

More information

ENGAGING PHARMACISTS IN 1305

ENGAGING PHARMACISTS IN 1305 ENGAGING PHARMACISTS IN 1305 UTAH EXAMPLES NICOLE BISSONETTE, MPH, MCHES EPICC PROGRAM MANAGER UTAH PROJECTS INVOLVING PHARMACISTS Prior to 1305 Select Health Pharmacist Hypertension Management Team Based

More information

The National Diabetes Prevention Program: An Update on Efforts in Michigan

The National Diabetes Prevention Program: An Update on Efforts in Michigan The National Diabetes Prevention Program: An Update on Efforts in Michigan Gretchen A. Piatt, PhD, MPH Assistant Professor Department of Medical Education University of Michigan 10/11/12 WHY PREVENT DIABETES?

More information

RN/Care Coordinator Roles In the Integrated Health Home

RN/Care Coordinator Roles In the Integrated Health Home RN/Care Coordinator Roles In the Integrated Health Home Nancy Delanoit, Taralyn Tranmer May 2014 The Magellan ICN, IHH site care coordinators and managed care nurses work together in a partnership to improve

More information

Dental Care and Chronic Conditions. Respiratory Disease Cardiovascular Disease Diabetes

Dental Care and Chronic Conditions. Respiratory Disease Cardiovascular Disease Diabetes Dental Care and Chronic Conditions Respiratory Disease Cardiovascular Disease Diabetes Shape Up Your Smile and Avoid Some Complications of Chronic Diseases When you take good care of your oral health,

More information

The Primary Health model: A collection of population health solutions & services

The Primary Health model: A collection of population health solutions & services The Primary Health model: A collection of population health solutions & services Creating health care alignment with an employer-driven network The United States spends more money on health care than any

More information

Diabetes Health Plan Member Guide

Diabetes Health Plan Member Guide Diabetes Health Plan Member Guide Welcome UnitedHealthcare Diabetes Health Plan Welcome to the Diabetes Health Plan. Our goal is to ensure you are getting the most out of your program. Please use this

More information

The Patient Centered Medical Home (PCMH): Looking at Examples. and Research on Staffing Models. Nancy Chang. GE-NMF PCLP Scholar 2013

The Patient Centered Medical Home (PCMH): Looking at Examples. and Research on Staffing Models. Nancy Chang. GE-NMF PCLP Scholar 2013 Running head: PATIENT CENTERED MEDICAL HOME 1 The Patient Centered Medical Home (PCMH): Looking at Examples and Research on Staffing Models Nancy Chang GE-NMF PCLP Scholar 2013 PATIENT CENTERED MEDICAL

More information

Care Coordination. The Embedded Care Manager. Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed

Care Coordination. The Embedded Care Manager. Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed Care Coordination The Embedded Care Manager Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed Goals of Care Management The goals of care Management are consistent with the Triple Aim: Improve population

More information

Self-Insured Schools of California: SISC PPO

Self-Insured Schools of California: SISC PPO Helping SISC III SELF-INSURED SCHOOLS OF CALIFORNIA Self-Insured of California: Helping SISC PPO Administered by Blue Shield of California 2013/2014 Enrollment Guide Blue Shield of California is proud

More information

For people with diabetes. A blood sugar diary

For people with diabetes. A blood sugar diary For people with diabetes A blood sugar diary A circle of help to live a healthy life YOU are at the center of a healthy life with diabetes. All the elements of good care begin and end with YOU. The importance

More information

Blood Sugar Testing. Bayer Health Facts

Blood Sugar Testing. Bayer Health Facts Blood Sugar Testing Bayer Health Facts What is Blood Sugar Testing? A blood sugar test tells you how much sugar is in your blood at the moment it is tested. Blood sugar is also called blood glucose. One

More information

The Jefferson Health Plan. Member Organization Wellness Program Incentive Guide July 1, 2015 June 30, 2016

The Jefferson Health Plan. Member Organization Wellness Program Incentive Guide July 1, 2015 June 30, 2016 The Jefferson Health Plan Member Organization Wellness Program Incentive Guide July 1, 2015 June 30, 2016 Incentive Programs Program Descriptions: As a means to encourage member groups to enroll in the

More information

THE ROLE OF HEALTH INFORMATION TECHNOLOGY IN PATIENT-CENTERED CARE COLLABORATION. 2012 Louisiana HIPAA & EHR Conference Presenter: Chris Williams

THE ROLE OF HEALTH INFORMATION TECHNOLOGY IN PATIENT-CENTERED CARE COLLABORATION. 2012 Louisiana HIPAA & EHR Conference Presenter: Chris Williams THE ROLE OF HEALTH INFORMATION TECHNOLOGY IN PATIENT-CENTERED CARE COLLABORATION 2012 Louisiana HIPAA & EHR Conference Presenter: Chris Williams Agenda Overview Impact of HIT on Patient-Centered Care (PCC)

More information

Personalized Therapy Algorithms for Type 2 Diabetes: A Phenotypization-based Approach

Personalized Therapy Algorithms for Type 2 Diabetes: A Phenotypization-based Approach Personalized Therapy Algorithms for Type 2 Diabetes: A Phenotypization-based Approach Riccardo Candido on behalf of the Personalized Therapy AMD Study Group Diabetes Canter A.S.S. 1 Triestina, Italy BACKGROUND

More information

Overcoming Barriers to Discharge for Home Infusion

Overcoming Barriers to Discharge for Home Infusion VOLUME 19 CORAM S CONTINUING EDUCATION PROGRAM Overcoming Barriers to Discharge for Home Infusion Successful home infusion therapy relies on timely and effective transitions to home. Early identification

More information

Your Medicine: Play It Safe

Your Medicine: Play It Safe Your Medicine: Play It Safe Learn more about how to take medicines safely. Use the Medicine Record Form at the back of this booklet to keep track of your medicines. Keep this guide with your medicines

More information

Diabetes: When To Treat With Insulin and Treatment Goals

Diabetes: When To Treat With Insulin and Treatment Goals Diabetes: When To Treat With Insulin and Treatment Goals Lanita. S. White, Pharm.D. Director, UAMS 12 th Street Health and Wellness Center Assistant Professor of Pharmacy Practice, UAMS College of Pharmacy

More information

Provider Community Pharmacist Team Management of Hypertension and Diabetes

Provider Community Pharmacist Team Management of Hypertension and Diabetes Provider Community Pharmacist Team Management of Hypertension and Diabetes William R. Doucette, Ph.D. University of Iowa College of Pharmacy Iowa Background Provider pharmacist team management of hypertension

More information

Healthy Living with Diabetes. Diabetes Disease Management Program

Healthy Living with Diabetes. Diabetes Disease Management Program Healthy Living with Diabetes Diabetes Disease Management Program Healthy Living With Diabetes Diabetes Disease Management Program Background According to recent reports the incidence of diabetes (type

More information

Understanding Group Health Insurance Anthem KeyCare 15+ Plan

Understanding Group Health Insurance Anthem KeyCare 15+ Plan Understanding Group Health Insurance Anthem KeyCare 15+ Plan January 12, 2010 Although it is the intent of the University to continue current benefit plans, the University reserves the right to modify,

More information

Self-Insured Schools of California:

Self-Insured Schools of California: Helping SISC III SELF-INSURED SCHOOLS OF CALIFORNIA Self-Insured of California: Helping Access+ HMO SaveNet 2013/2014 Enrollment Guide Blue Shield of California offers health benefits to school districts

More information

Chronic Care Management. WPS Chronic Care Management Next Generation Disease Management

Chronic Care Management. WPS Chronic Care Management Next Generation Disease Management Chronic Care Management WPS Chronic Care Management Next Generation Disease Management Taking on Chronic Illness and Winning. People with chronic illnesses make up only 20 percent of your employee population,

More information

Enhance your practice. Enhance patient care.

Enhance your practice. Enhance patient care. FPN Layout final Sept 7 9/8/06 10:54 AM Page 6 Enhance your practice. Enhance patient care. A Case for Change The surveys tell us patients are, for the most part, satisfied with the health care they receive.

More information

Welcome to Crozer-Keystone Health Network Primary Care

Welcome to Crozer-Keystone Health Network Primary Care Welcome to Crozer-Keystone Health Network Primary Care A Guide to Your CKHN Patient-Centered Medical Home: What you can expect from us... What we will need from you......so you can gain the full benefits

More information

Diabetes Self Management Training Insulin Pump Follow Up

Diabetes Self Management Training Insulin Pump Follow Up 701 East Marshall Street, West Chester, PA 19380 www.chestercountyhospital.org 610.431.5000 Diabetes Self Management Training Insulin Pump Follow Up Patient Name: Visit Date: Time: To prepare for your

More information

You re one step closer to simple health care.

You re one step closer to simple health care. welcometouhc.com You re one step closer to simple health care. SIMPLE - A GUIDE TO YOUR 2016 UNITEDHEALTHCARE BENEFITS Health care can be hard. We re here to help you through it. You can count on us to

More information

Maximizing Limited Care Management Resources to Improve Clinical Quality and Ensure Safe Transitions

Maximizing Limited Care Management Resources to Improve Clinical Quality and Ensure Safe Transitions Maximizing Limited Care Management Resources to Improve Clinical Quality and Ensure Safe Transitions Scott Flinn MD Deborah Schutz RN JD Fritz Steen RN Arch Health Partners A medical foundation formed

More information

10/21/2014. Clinical Innovations in the Patient Centered Medical Home to Improve Diabetes Care

10/21/2014. Clinical Innovations in the Patient Centered Medical Home to Improve Diabetes Care Clinical Innovations in the Patient Centered Medical Home to Improve Diabetes Care Robert A. Gabbay, MD, PhD, FACP Chief Medical Officer & Senior Vice President Joslin Diabetes Center Harvard Medical School

More information

Section 504 Plan (pg 1 of 8)

Section 504 Plan (pg 1 of 8) Section 504 Plan (pg 1 of 8) of Birth School Today s Section 504 Plan for: Disability: Diabetes School Year: Grade: Homeroom Teacher: Bus Number: Background Objectives The student has type diabetes. Diabetes

More information

RED, BOOST, and You: Improving the Discharge Transition of Care

RED, BOOST, and You: Improving the Discharge Transition of Care RED, BOOST, and You: Improving the Discharge Transition of Care Jeffrey L. Greenwald, MD, SFHM Massachusetts General Hospital - Clinician Educator Service Co-Investigator Project RED & Project BOOST The

More information

Patient Centered Medical Home. Nancy Chang, Adelante, Phoenix

Patient Centered Medical Home. Nancy Chang, Adelante, Phoenix Patient Centered Medical Home Nancy Chang, Adelante, Phoenix Introduction US healthcare system is broken Medical care is very expensive, but poor in quality and delivery Patient Centered Medical Home (PCMH)

More information

WORKING TOGETHER. Manjunath, R.Ph., and Andrea Ball, R.Ph.T of Zehrs Pharmacy in Brantford, Ontario

WORKING TOGETHER. Manjunath, R.Ph., and Andrea Ball, R.Ph.T of Zehrs Pharmacy in Brantford, Ontario WORKING TOGETHER 8 Santosh Manjunath, R.Ph., and Andrea Ball, R.Ph.T of Zehrs Pharmacy in Brantford, Ontario PHARMACISTS AND TECHNICIANS ARE TEAMING UP IN ONTARIO COMMUNITIES TO DELIVER PATIENT CARE It

More information

Part 1: Complete the following steps using the first half of the Patient Verification worksheet:

Part 1: Complete the following steps using the first half of the Patient Verification worksheet: Patient Verification Manager s Training Guide You will facilitate a 45 minute training session with your team to review important key procedures for Patient Verification. This guide will help you deliver

More information

Burns & McDonnell On-Site Clinic

Burns & McDonnell On-Site Clinic Burns & McDonnell On-Site Clinic A Prescription for Financial and Productivity Success Fall 2013 Lockton Companies C OMPAN Y P R OFI L E Engineering, architecture, construction, environmental and consulting

More information

Self-Insured Schools of California: Schools Helping Schools

Self-Insured Schools of California: Schools Helping Schools Self-Insured Schools of California: Schools Helping Schools FOUNDATION SISC PPO PLAN Administered by Blue Shield of California 2014/2015 Enrollment Guide Blue Shield of California is proud to be the benefit

More information

Special Needs Programs Overview. Diabetes

Special Needs Programs Overview. Diabetes Special Needs Programs Overview Brand New Day health plan has several special programs for individuals with one or more of the following chronic conditions: Diabetes, Dementia, or Mental Illness. Below

More information

How to get the most of your blood glucose readings

How to get the most of your blood glucose readings How to get the most of your blood glucose readings Page 3 Page 4 Page 5 Page 5 Page 7 Page 7 Page 8 Page 9 Page 10 Page 11 1 Why you should do blood glucose monitoring? 2 How to do it correctly? 3 Who

More information

If you have a question about whether MedStar Family Choice covers certain health care, call MedStar Family Choice Member Services at 888-404-3549.

If you have a question about whether MedStar Family Choice covers certain health care, call MedStar Family Choice Member Services at 888-404-3549. Your Health Benefits Health services covered by MedStar Family Choice The list below shows the healthcare services and benefits for all MedStar Family Choice members. For some benefits, you have to be

More information

Community Health Worker Led Diabetes Coaching within the Medical Home

Community Health Worker Led Diabetes Coaching within the Medical Home Community Health Worker Led Diabetes Coaching within the Medical Home Christine Snead, RN Erin Kane, MD Baylor Scott & White Health www.alliancefordiabetes.org Objectives Identify tools, resources and

More information

Metabolic Syndrome Programs Designed to Lower Risks

Metabolic Syndrome Programs Designed to Lower Risks Metabolic Syndrome Programs Designed to Lower Risks BACKGROUND Affecting one in four adults in the U.S., metabolic syndrome is one of the fastest growing healthcare crises facing the nation today. Metabolic

More information

Collaborative Onsite Medical Care in the Workplace

Collaborative Onsite Medical Care in the Workplace Collaborative Onsite Medical Care in the Workplace Sue Dierksen, MPH,RN, COHN-S/CM, CSP Director of Business Health- Aspirus Clinics Holly Bauer, RN BSN Health Services Supervisor, Sentry Insurance Objectives

More information

Implementing an RN Protocol for Uncomplicated Hypertension

Implementing an RN Protocol for Uncomplicated Hypertension RN Hypertension Protocol Joyce Cheung, RN KP, Orange County Karen Sielbeck, RN KP, South Bay Noshin Afrookhteh, RN KP, Orange County Implementing an RN Protocol for Uncomplicated Hypertension Protocol

More information