The Endocrine Society and Avalere Health have launched a first of its kind quality improvement intervention study in primary care practice to address the clinical gaps in identifying and treating hypoglycemia in older adults with type 2 diabetes.
The Society and Avalere have partnered with Pottstown Medical Specialists (PMSI), a physician-owned multispecialty group in Pottstown, Pa., as the first primary care site for the quality improvement study. PMSI began enrolling patients in June.
An estimated 33 percent of adults aged 65 or older have diabetes. This age group is particularly at risk for hypoglycemia, or low blood sugar, associated with treatment using insulin and/or sulfonylurea medications. Hypoglycemia can cause episodes of dangerously low blood sugar that can lead to seizures, coma and even death. The U.S. Department of Health and Human Services has identified hypoglycemia as one of the top three preventable and measurable adverse drug events.
“Hypoglycemia can harm patients with diabetes and leads to significant healthcare costs. Our new quality improvement study is designed to evaluate tools and processes in primary care that can hopefully reduce the risk of hypoglycemia in older patients with type 2 diabetes,” says Jeffrey Boord, MD, MPH, of Parkview Health in Fort Wayne, Ind. Boord is the Chair of the Steering Committee that developed the Hypoglycemia Prevention Initiative. “PMSI’s strong commitment to providing patients with diabetes with self-management training is illustrated by their accreditation from the American Association of Diabetes Educators as a Diabetes Self-Management Education and Support program, make it an ideal partner for evaluating our hypoglycemia prevention interventions in a real-world primary care setting,” he says.
The cost and frequency of hypoglycemia is high and is often under recognized as a public health problem. In 2009, hypoglycemia resulted in nearly 300,000 emergency room visits of adult patients with type 1 or type 2 diabetes. For Medicare beneficiaries in 2010, hospitalization resulting from hypoglycemia was associated with 30-day readmission and 30-day mortality rates of 18 percent and 5 percent, respectively.
“Avalere is excited to be a part of this groundbreaking quality initiative to help treat older adults who are at risk of developing hypoglycemia,” says Kristi Mitchell, practice director at Avalere Health. “Collaboration is key when comes to addressing complex and chronic diseases. We look forward to continuing our work on the HypoPrevent study so that we can provide primary care physicians with the necessary tools to identify and treat patients at-risk for developing hypoglycemia.”
The quality improvement study, HypoPrevent, evaluates a two-pronged intervention in primary care practice. The first part is a screening tool that identifies older patients with diabetes at risk of treatment-related hypoglycemia. The second is a clinical decision support tool that facilitates shared decision making with patients on ways to reduce their risk of hypoglycemia through the individualization of blood sugar goals and/or changes in medication management.
“We are committed to delivering the highest quality medical healthcare through the coordination of properly planned, managed and utilized medical services,” says Wade Brosius, DO, PMSI medical director. “Our partnership with the Society and Avalere will help us improve patient safety through a systems-based approach and make a major impact on the burden of hypoglycemia among older adults with diabetes.”
In conjunction with HypoPrevent, the Society formed a technical expert panel to develop quality measures—tools that help us measure or quantify healthcare processes, outcomes, patient perceptions, and organizational structure—to reduce the risk of hypoglycemia in the outpatient setting. These measures will be designed to allow providers to identify areas for improvement and track the success of their efforts, ultimately leading to reduced hypoglycemia.
The Hypoglycemia Prevention Initiative is funded by Merck, Novo Nordisk, Lilly, Sanofi, and Abbott.