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174-LB: Impact of Quality Improvement (QI) Program on 5-Year Risk of Diabetes-Related Complications

Authors :
Roy E. Furman
Hui Shao
Lizheng Shi
Timothy S. Harlan
Luigi F. Meneghini
Vivian Fonseca
Source :
Diabetes. 68
Publication Year :
2019
Publisher :
American Diabetes Association, 2019.

Abstract

We have successfully implemented the ADA’s Diabetes INSIDE® QI program at a University hospital and safety-net health system (Tulane and Parkland), focused on system-wide improvement in poorly controlled type 2 diabetes (A1c>8.0%). We extrapolated clinical outcomes of the QI program on a 5-year risk of complications, utilizing a validated risk prediction model: Building, Relating, Assessing, Validating of Outcomes (BRAVO) simulation model. We measured the differences between the baseline and post-intervention values of risk factors in 2,429 individuals with A1c >8% at baseline and used the BRAVO model to project the 5-year risk reduction of diabetes-related complications under the assumption that intervention benefits diminished with time. The intervention period was defined as one year and the post-intervention period as the subsequent six months. The QI program was associated with reductions in A1c (-0.84%) and LDL-C (-5.94 mg/dl) among individuals with A1c level >8.0%, with greater reduction in A1c (-1.67%) and LDL-C (-6.81 mg/dl) among those with A1c level > 9.5% at baseline (all p Disclosure H. Shao: None. L. Shi: None. R.E. Furman: None. L. Meneghini: Advisory Panel; Self; AstraZeneca, Novo Nordisk Inc., Sanofi-Aventis. Consultant; Self; Sanofi-Aventis. Other Relationship; Self; American Diabetes Association. T.S. Harlan: None. V. Fonseca: Board Member; Self; American Association of Clinical Endocrinologists. Consultant; Self; Abbott, Asahi Kasei Corporation, Novo Nordisk Inc., Sanofi US, Takeda Pharmaceutical Company Limited. Research Support; Self; Bayer US. Stock/Shareholder; Self; Amgen Inc., Bravo4health, Mellitus Health. Funding Lilly USA, LLC; Novo Nordisk; Sanofi

Details

ISSN :
1939327X and 00121797
Volume :
68
Database :
OpenAIRE
Journal :
Diabetes
Accession number :
edsair.doi...........7875243c83bfc326869a182dd26c0dfd
Full Text :
https://doi.org/10.2337/db19-174-lb