- Published in Disease Management (now Population Health Management) -

Improvement of LDL-C Laboratory Values Achieved by Participation in a Cardiac or Diabetes Disease Management Program

Author(s): Patty Orr, MSN, RN, EdD; Adam Hobgood, MS; Sadie Coberley, PhD; Patricia Roberts, RN, MS, CNN; Gerrye Stegall, MSN, RN; Carter Coberley, PhD and James Pope, MD

Population Health ManagementPoor lipid control is a risk factor for cardiovascular diseases and diabetes complications. Frequently, however, patients with these diseases do not achieve blood lipid levels recommended by current standards of care. A retrospective study of 67,244 members eligible for disease management (DM) was initiated to evaluate the ability of interventions to promote improvement in low-density lipoprotein cholesterol (LDL-C) laboratory values for people with cardiovascular diseases or diabetes. The baseline trend in improving LDL-C values in the absence of DM was established. A two-year period prior to the start of the DM intervention was examined to measure the mean percent change in LDL-C values that was occurring in the population. The mean percent change observed for this pre-intervention group was then compared to the change in LDL-C values observed during the DM study period. A significant reduction in elevated LDL-C values (F-test; p0.0001) was observed for members who participated in the DM interventions, even when elevated LDL-C was defined as low as 70mg/dL. Members with LDL-C values within threshold limits maintained these levels during the DM program. The significant reduction in elevated LDL-C values and maintenance of optimal values (100 mg/dL) was observed over the course of 3 years of participation in a DM program. A subset of the population also was examined to assess the impact of telephonic intervention on reducing elevated LDL-C values. A significant relationship between receiving care calls and reduction in elevated LDL-C levels was observed; members who received calls achieved up to a 32.5% relative reduction in elevated LDL-C values compared to members who did not receive calls. In conclusion, these findings demonstrate the ability of DM interventions to assist a large, geographically diverse member population in reducing a clinical laboratory value.

(Disease Management 2006;9:360–370)

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Topics: Health Conditions Performance/Productivity Peer Reviewed Health Plan & Health System Standards of Care