Evaluation of a diabetes management program using selected HEDIS measures

Abstract

ObjectiveTo evaluate the efficacy of a community-based, pharmacist-directed diabetes management program among managed care organization enrollees using National Committee for QualityAssurance (NCQA)–Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. DesignRandomizedcontrolled trial. SettingRegional community pharmacy chain in Tulsa, OK, from November 2005 to July 2007. Patients52 participants with diabetes and hypertension who were enrolled in a managed care organization. InterventionDiabetes management versus standard care. Main outcome measuresComprehensive diabetes care measures of glycosylated hemoglobin (A1C <7.0%), blood pressure (<130/80mm Hg), and low-density lipoprotein (LDL) cholesterol (<100 mg/dL). A composite research outcome of success was created by determiningwhether a participant achieved two of the three HEDIS goals at the end of9 months. Results46.7% of intervention group participants achieved theA1C goal, while 9.1% of control group participants achieved the goal (P < 0.002).More than one-half (53.3%) of intervention participants achieved theblood pressure goal comparedwith 22.7% of control participants (P < 0.02).Among control group participants, 50% achieved theLDL cholesterol goal compared with 46.67% of intervention group participants. The odds of the intervention group attaining the composite goal were5.87 times greater than the control group. ConclusionA communitypharmacy–based diabetes management program was effective in achievingA1C andblood pressure goals measured byNCQA–HEDIS performance standards. Program participants werestatistically significantly more likely to achieve two of three HEDIS standardsduring a 9-month period.