Goal attainment in patients referred to a telephone-based dyslipidemia program

Palmieri, James R.; Redline, Shannon; Morita, Richard

doi:10.2146/ajhp040343

Cited by 7 publications

(12 citation statements)

References 23 publications

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“…The Mercy Heart Institute' sC DCM program described in this paper was previously shown to improve LDL-C goal attainment for diabetes patients from 23.2% beforet he intervention to 56% after only 6m onths in the program. 14 This 56% rate of LDL-C goal attainment compares with 47% in the present study.…”

Section: ■■ Conclusionsupporting

confidence: 48%

“…Results of other studies on the effectiveness of team-based lipid management have also shown high LDL-C lab testing rates (96.7%-97.3%) and LDL-C <100 mg per dL goal attainment (56.5%-83.3%) in lipid management. [13][14][15] Limitations of those studies include no patient randomization, no comparator-control group, and no evaluation of end point outcomes such as morbidity or mortality.T his is the first study to pair the clinical results of team-based CDCM with emerging P4P initiatives showing both improved quality reporting and potential increased revenue for the medical group.…”

Section: ■■ Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of the Relationship Between a Chronic Disease Care Management Program and California Pay-for-Performance Diabetes Care Cholesterol Measures in One Medical Group

Cutler¹,

Palmieri²,

Khalsa³

et al. 2007

JMCP

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ConTeMPoRARyS uBJeCTpayment from the health plan was$1per member per month (PMPM), or $57,024 if the total incentive P4P payment was$2PMPM.COnClusiOns: Preliminarydata from 165 patients with diabetes managed in aCDCM programinamedical group operating under asmall P4P financial incentive showed higher rates of lDl-C lab testing and goal attainment than from patients managed by routine care. Had these rates of lDl-C testing and goal attainment achieved in the CDCM programbeen extended to the entire P4P population with diabetes, this medical group would have generated incentive payments under the P4P programand ranked higher in publicly available quality scores. What is already known about this subject•P ay for Performance (P4P) programs alone have not been shown to improve quality of care.•C hronic disease caremanagement (CDCM) programs have reportedly attained high rates of low-density lipoprotein cholesterol (LDL-C) testing (96.7%-97.3%) and goal LDL-C <100 mg per dL (56.5%-83.3%) for patients with diabetes, but the study methods have lacked patient randomization. What this study adds•T his is the first study to show the potential impact that CDCM may have on the P4P rankings and financial payouts for amedical group. P ay for performance (P4P) is ab usiness model by which health plans pay provider organizations (medical groups) for consistently demonstrating high levels of quality performance based on established criteria. 1-4The results of the P4P clinical measures arep ublicly available and areo ften discussed during contract negotiations between medical groups and health plans. California has the largest and most comprehensive P4P program; however,P 4P programs exist nationwide. [1][2][3][4][5][6] In fact, ar ecent survey demonstrated that most health plans that offer commercial health maintenance organization (HMO) products BaCKGROunD: Pay for performance (P4P) is abusiness model in whichhealth plans pay provider organizations (medical groups) financial incentives based on attainment of clinical quality,patient experience,and use of information technology.The California P4P programisthe largest P4P programinthe united states and represents apotential revenue source for all participating medical groups. The clinical specifications for the California P4P programare based on the national Committee for Quality assurance (nCQa), Health Plan EmployerData, and information set (HEDis), and eachclinical measurehas its ownbenchmark. in 2005, participating medical groups werepaid on the basis of 9clinical measures that wereevaluated in the 2004 measurement year. The cholesterol testing measurerepresented 4.44%-7.14% of the total P4P dollars available to participating medical groups from the health plans.

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Section: ■■ Conclusionsupporting

confidence: 48%

Section: ■■ Discussionmentioning

confidence: 99%

Evaluation of the Relationship Between a Chronic Disease Care Management Program and California Pay-for-Performance Diabetes Care Cholesterol Measures in One Medical Group

Cutler¹,

Palmieri²,

Khalsa³

et al. 2007

JMCP

Self Cite

View full text Add to dashboard Cite

show abstract

“…Despite the adoption of the national cholesterol education program (NCEP) guidelines, our study shows that patients were more likely to improve their lipid levels and attain their treatment goals when managed with pharmacist intervention than with usual medical practice. Reduction of cholesterol levels have been reported in patients receiving pharmaceutical care (8,(20)(21)(22)(23)(24). Peterson et al reported that a 7-month pharmacist-conducted educational and monitoring programme resulted in cholesterol levels being controlled to below 4AE0 mmol ⁄ L in 44% of the 39 patients in their intervention group compared with 24% of 42 patients in their control (P = 0AE06) (21).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The precise reason for better hypertension and lipid control with pharmacist intervention is not clear. In published studies, the pharmacist played an active role in providing patient education about drug therapy, treatment goals, benefits of therapy, the importance of compliance and the monitoring of adverse effect, and this might have helped (22, 25). This increased information flow may also explain our success in MRF control.…”

Section: Discussionmentioning

confidence: 99%

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Control of modifiable risk factors in ischemic stroke outpatients by pharmacist intervention: an equal allocation stratified randomized study

Chiu

Lee

et al. 2008

Journal of Clinical Pharmacy and Therapeutics

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Describing the delivery of clinical pharmacy services via telehealth: A systematic review

Melton

Jasmin

Johnson

et al. 2021

J Am Coll Clin Pharm

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IntroductionTelehealth offers a promising opportunity for the delivery of clinical pharmacy services by increasing the accessibility of health care, extending the reach of clinical services, and allowing pharmacists to engage with patients who might otherwise be overlooked. The objectives of the project were to discover effective strategies for the delivery of clinical pharmacy services via telehealth and to identify core components of comprehensive medication management (CMM) that are deliverable via telehealth.MethodsA systematic literature review was performed by searching four databases (Cumulative Index to Nursing and Allied Health Literature [CINAHL], PubMed, Scopus, and Web of Science) for relevant citations using keywords and subject headings relating to telemedicine, clinical pharmacy services, and health conditions. Studies were eligible for inclusion in the review if the interventions they describe involved telehealth technologies and pharmacist care. Blind screening of abstracts and full‐text review was completed by six researchers divided into teams of two. Any discrepancies were resolved by the corresponding author.ResultsFifty‐nine studies met the inclusion criteria, most (n = 53) of which were conducted in the U.S. Five studies (8.5%) reported pharmacist training as an implementation strategy. The telehealth technologies most regularly utilized were telephone‐based interventions (n = 45), videoconferences (n = 13), and web‐based (n = 4) interventions, with five studies using a combination of technologies. Most studies focused on hypertension (n = 22), diabetes (n = 20), or lipid‐related (n = 14) disease state management. Eighteen studies qualified as CMM (n = 18), with most involving all five essential CMM functions.ConclusionThis systematic review study highlights opportunities for pharmacists to deliver clinical pharmacy services using telehealth. The majority of clinical pharmacy services described in the accessed literature was provided via telephone and focused on targeted monitoring of disease states. While studies reporting the use of CMM interventions were limited, there is an opportunity to increase the application of CMM principles as healthcare systems transition to providing more telehealth services.

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Goal attainment in patients referred to a telephone-based dyslipidemia program

Abstract: LDL-C goal-attainment rates increased in patients referred to a telephone-based hyperlipidemia management program.

Cited by 7 publications

References 23 publications

Evaluation of the Relationship Between a Chronic Disease Care Management Program and California Pay-for-Performance Diabetes Care Cholesterol Measures in One Medical Group

Evaluation of the Relationship Between a Chronic Disease Care Management Program and California Pay-for-Performance Diabetes Care Cholesterol Measures in One Medical Group

Control of modifiable risk factors in ischemic stroke outpatients by pharmacist intervention: an equal allocation stratified randomized study

Describing the delivery of clinical pharmacy services via telehealth: A systematic review

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