PROPAT: A study to improve the quality and reduce the cost of diabetes care

Gagliardino, Juan José; Olivera, Ercilia M; Etchegoyen, Graciela; Guidi, María; Caporale, Joaquín; Martella, Analía; Hera, M De La; Siri, Fernando; Bonelli, P.

doi:10.1016/j.diabres.2006.02.004

Cited by 22 publications

(34 citation statements)

References 17 publications

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“…Interestingly, despite the significant increase in procedure performance, none of the values reached 100% either 1 or 3 years after DPO implementation, even when costs were fully covered by the DPO. Similar data were recorded with PROPAT,18,19 thus showing how difficult it is to remove long-established inappropriate routines.…”

Section: Discussionsupporting

confidence: 54%

“…In our country, the implementation of PROPAT, an example of this type of controlled program, also showed such a dual beneficial impact 18,19…”

Section: Discussionmentioning

confidence: 84%

“…Such an assertion is supported by the significant improvement in several clinical and metabolic indicators of quality of care of people with type 2 diabetes and the decrease in direct medical costs observed after the implementation of Program for the Prevention, Care and Treatment of People with Diabetes (PROPAT) in Argentina18,19 and similar initiatives in other countries. PROPAT was a controlled study, but there is no evidence of the efficacy of this type of program in “real world” conditions.…”

Section: Introductionmentioning

confidence: 94%

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Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

González¹,

Elgart²,

Calvo³

et al. 2013

CEOR

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PurposeTo measure the impact of a diabetes and cardiovascular risk factors program implemented in a social security institution upon short- and long-term clinical/metabolic outcomes and costs of care.MethodsObservational longitudinal cohort analysis of clinical/metabolic data and resource use of 300 adult male and female program participants with diabetes before (baseline) and 1 and 3 years after implementation of the program. Data were obtained from clinical records (Qualidiab) and the administration’s database.ResultsThe implementation of the program in “real world” conditions resulted in an immediate and sustainable improvement of the quality of care provided to people with diabetes incorporated therein. We also recorded a more appropriate oral therapy prescription for hyperglycemia and cardiovascular risk factors (CVRFs), as well as a decrease of events related to chronic complications. This improvement was associated with an increased use of diagnostic and therapeutic resources, particularly those related to pharmacy prescriptions, not specifically used for the control of hyperglycemia and other CVRFs.ConclusionThe implementation of a diabetes program in real-world conditions results in a significant short- and long-term improvement of the quality of care provided to people with diabetes and other CVRFs, but simultaneously increased the use of resources and the cost of diagnostic and therapeutic practices. Since controlled studies have shown improvement in quality of care without increasing costs, our results suggest the need to include management-control strategies in these programs for appropriate medical and administrative feedback to ensure the simultaneous improvement of clinical outcomes and optimization of the use of resources.

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Section: Discussionsupporting

confidence: 54%

“…In our country, the implementation of PROPAT, an example of this type of controlled program, also showed such a dual beneficial impact 18,19…”

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 94%

See 1 more Smart Citation

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

González¹,

Elgart²,

Calvo³

et al. 2013

CEOR

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“…The figures in Argentina are similar to those reported in the United States in 2009. A multicenter study published by Dr. Villariño et al in 2014 showed considerably increased prevalence of T2D (from 7.9 to 10.8% overall in both genders) and obesity (from 26 to 33%) in the central area of Argentina 31 .…”

Section: Argentinamentioning

confidence: 99%

HbA1c measurement in diabetes diagnosis and management of diabetes in latin: proceedings of the San Pablo Symposium

Gagliardino¹

2020

ALAD

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“…8 On the other hand, reported evidence has shown that SMBG would facilitate the achievement of treatment goals and decrease the costs of care. 9,10 While the benefits of SMBG in people with type 1 (T1DM) or type 2 diabetes (T2DM) treated with insulin are widely accepted, its performance in patients with T2DM treated with oral antidiabetic drugs (OAD) or lifestyle changes has been seriously challenged. 11 Given the high cost of the current T2DM care and the fact that its prevalence continues to grow worldwide, many efforts have been made to determine whether economic support to SMBG in noninsulin-treated T2DM patients is justified and effectively applied.…”

mentioning

confidence: 99%

Self-Monitoring of Blood Glucose

Elgart

González

Rucci

et al. 2014

J Diabetes Sci Technol

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Although test strips for self-monitoring of blood glucose (SMBG) represent around 50% of diabetes treatment cost in Argentina, little is known about their current use and relationship with different types of treatment. We therefore aimed to estimate the current use of test strips and identify the major use drivers and the percentage they represent of total prescription costs in 2 entities of the social security system (SSS) of Argentina. Observational retrospective study measuring test strip prescriptions delivered by pharmacies from the province of Buenos Aires (8115 records collected during 3 months provided by the Colegio de Farmacéuticos de la Provincia de Buenos Aires) of affiliates with type 2 diabetes (T2DM) from 2 large entities of the SSS system. The average monthly test strips/patient used for SMBG was 97.5 ± 70.1. This number varied according to treatment: monotherapy with oral antidiabetic drugs (OAD) < combined OAD therapy < insulin treatment. Test strips represented a higher percentage of the total prescription cost in people under OAD monotherapy (84.6%) and lower in those with insulin analogs (46.9%). In our population, the type of hyperglycemia treatment was the main driver of test strip use for SMBG and its impact on the total prescription cost depends on the kind of such treatment. Since it has been shown that patients' education and prescription audit can optimize test strip use and treatment outcomes, implementation of such strategies could appropriately support, optimize, and reduce ineffective test strip use in people with T2DM.

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PROPAT: A study to improve the quality and reduce the cost of diabetes care

Cited by 22 publications

References 17 publications

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

Changes in quality of care and costs induced by implementation of a diabetes program in a social security entity of Argentina

HbA1c measurement in diabetes diagnosis and management of diabetes in latin: proceedings of the San Pablo Symposium

Self-Monitoring of Blood Glucose

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