Advisor
Taveira, Tracey [faculty advisor, Department of Pharmacy]
Date
5-2009
Keywords
diabetes; multidisciplinary; assistance; health care; medical insurance
Abstract
This retrospective chart review is to evaluate the changes in personal health markers that serve as prognostic indicators in the progression of type 2 diabetes mellitus. Subjects in the Patient Assistance Liaison (PAL) Program at the Diabetes Resource Center (DRC) of the St. Joseph Health Services of Rhode Island Hospital for Specialty Care have no health insurance to pay for needed services and medications. It is desirable to know if the care they are receiving is equivalent to patients at the DRC that have prescription drug insurance from a third party provider.
Presently there are over 23.6 million Americans with diabetes, many of whom are underinsured or uninsured. Patient assistance programs have been proposed to be an effective model to improved outcomes in chronic diseases. However, little is known about their effectiveness in diabetes care. Diabetes is an independent cardiovascular risk factor accounting for myocardial infarction, blindness, kidney disease and nerve pain. Assessing electronic medical records of selected patients in the DRC database from baseline to twelve months later can show how effective the PAL program is.
The primary outcome of interest is the change in hemoglobin A1C (HbA1c). This value describes the average glucose level in a patient’s blood stream over the preceding three months. Secondary outcomes will be changes in blood pressure, serum lipids, and patient body mass index. A statistical analysis of the data will be performed between the data sets of PAL Program patients and insured patients to show significance. It is our hope that the data will serve as pilot data to determine if a prospective, randomized-control pilot study should be performed to evaluate the efficacy of patient assistance program strategies in reducing the overall cardiovascular risk of patients with type 2 diabetes.