Year of Publication

2005

College

Martin School of Public Policy and Administration

Executive Summary

Diabetes is a serious illness affecting millions of people in the United States today. The disease is characterized by the chronic and acute complications of poorly regulated blood glucose concentrations. These complications lead to significant morbidity and mortality in the diabetic population. It is estimated that diabetes accounts for over $1.9 billion in Kentucky healthcare expenditure annually, a figure that continues to grow each year. In order to address this serious public health problem, many states have adopted healthcare initiatives to target increased diabetes awareness and care. The Commonwealth of Kentucky has implemented numerous such initiatives, including an innovative program of university based academic detailing.

The Drug and Therapeutics Information Service (DATIS) is a program affiliated with the University of Kentucky College of Pharmacy designed to provide area primary care physicians with evidence-based guidelines for the treatment of public health concerns. This program utilizes clinical pharmacists to review current primary literature surrounding a topic of interest, prepare condensed reference materials based on the salient points of this literature, and participate in one-on-one academic detailing sessions with area providers. The program is currently funded by federal grants with the potential for transition to state support, prompting the need for audit.

Management of Type II diabetes was the initial focus of the DATIS group. The impact of the DATIS detailing sessions was assessed using Kentucky Medicaid data. The frequency of hemoglobin A1c assessment in the area of intervention was compared the frequency of assessment in a control area. Statewide hemoglobin A1c assessment was tracked over the same timeframe. No significant difference in assessment frequency was noted between the intervention and control areas. However, an overall statewide increase in assessment frequency was noted over the course of the analysis. These results suggest that further analysis may be necessary to determine the impact of the DATIS intervention on diabetes care in the Commonwealth of Kentucky.

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