A Comparison of Intermediate Outcomes of Diabetes Care in the Diabetes Information and Support for your Health (DISH) Program in the Jefferson Family Medical Associates Practice
The purpose of this study was to determine how the DISH program affected medication prescribing and intermediate outcomes of diabetes care in the JFMA practice. A matched comparison group design was used to compare the change from baseline in the proportion of DISH program participants and non-participants who achieved a hemoglobin A1c < 7%, < 8% and > 9%; a low density lipoprotein (LDL) blood concentration < 130 mg/dL and < 100 mg/dL; a blood pressure (BP) < 140/90 mm Hg and < 130/80 mm Hg, and weight loss during the follow-up period. DISH participants were matched to non-participants on age category, gender, race/ethnicity and zip code group, a surrogate marker for socioeconomic status. DISH participants attended at least one program session between measurement of outcome variables in the baseline and follow-up periods. The distribution of demographic characteristics and co-morbidities was similar between the DISH and comparison groups. The median number of DISH sessions participants attended was 1. Forty-six percent attended at least 3 of 4 sessions. A statin, and either an angiotensin converting enzyme inhibitor or an angiotensin receptor blocker were prescribed for a similar proportion of patients in both groups. The proportion of DISH participants achieving a BP < 140/90 mm Hg increased compared to the comparison group (CMH=3.99, p=0.046) and after controlling for baseline BP (CMH =5.61, p=0.018). The increase in the proportion of DISH participants achieving the target A1c (CMH= 2.97, p=0.085 for A1c < 7% adjusted for baseline) and LDL concentrations did not achieve the 0.05 level of significance. . The difference between the groups in the proportion of diabetics who lost weight was not significant, although the median weight change in the DISH group was greater (-3.5 pounds vs. -1 pound). Participation in the DISH program was associated with improvement in blood pressure control.
Recommended CitationReitz, Jeffrey A., "A Comparison of Intermediate Outcomes of Diabetes Care in the Diabetes Information and Support for your Health (DISH) Program in the Jefferson Family Medical Associates Practice" (2010). Master of Public Health Thesis and Capstone Presentations. Presentaion 20.