Category: Health and Health Care

10 - The Impact of Individualizing Glycemic Targets Training on Improving Diabetes Care in Older Adults

Background


Diabetes is one of three high priority drug classes targeted in the National Action Plan for ADE Prevention (NAP ADE). Diabetes agents are implicated in 13% of ED visits for adverse drug events (ADEs). Patients present with hypoglycemia 90% of the time, and 39% of cases result in hospitalization. According to the Standards of Medical Care in Diabetes, older adults are at an increased risk for experiencing hypoglycemia as a result of ADEs, and it is critical for health care providers to have tools and resources available to assist in individualizing glycemic goals for older patients through a shared-decision making process.


 


Since the launch of the NAP ADE in 2014, federal agencies have collaborated with researchers, professional organizations, and practitioners to reduce ADEs, including hypoglycemia secondary to diabetes agents. Under the leadership of the Office of Disease Prevention and Health Promotion (ODPHP), the Federal Interagency Steering Committee, and Federal Interagency Workgroups (FIW) have focused on medication safety as well as patient and family engagement.


 


ODPHP, in collaboration with the FIW for Diabetes, has developed an eLearning course, Preventing Adverse Drug Events: Individualizing Glycemic Targets Using Health Literacy Strategies. The tool trains health providers on the application of health literacy principles to help patients understand and act on information to prevent ADEs due to diabetes agents. Users work through various modules that highlight the importance of setting glycemic goals based on individual factors. This training is designed to provide a framework for diabetes management in elderly patients, and to encourage providers to assess the medical, mental, function, and social considerations associated with these patients as they age.


 


Methods


 


Since September 2014, ODPHP has collected demographical analytics on providers who have registered, completed/passed, and have obtained continuing education credits for the training (e.g. CME, CNE, CEU, CPE). ODPHP receives data on a periodic basis. The data provide insight on knowledge gaps in hypoglycemia awareness and areas for improvement for future prevention efforts.


 


Outcomes


 


As of December 31 2017, 730 providers registered for the training. 84.1% of those who registered were able to complete the training, and 99.7% passed. Nurses were by far the highest demographic (63.7%), followed by pharmacists (10.4%). Physicians were among the lowest registrants (4.79%). The highest completion rate was among non-physicians (88.52%), while the lowest was among physicians (68.6%).


 


 

Ndome Essoka

ORISE Health Policy Fellow
USDHHS/OASH/ODPHP/DHCQ

Ndome Yvonne Essoka received her B.S in Health Sciences with a concentration in Healthcare Management from Stony Brook University, and an M.P.H with a concentration in Health Systems and Policy from Rutgers University. Ndome has worked with various organizations such as NACCHO (National Association of City and County Health Officials) where as a Health Policy Scholar, she was able to edit and update various policy statements as well as interview many local health departments on their public health successes. She has also worked with VISN (Veteran Integrated Service Network) 20 of the U.S Department of Veteran Affairs in Washington State as a Health Policy Intern where she was able to do extensive research and analyze policies pertaining to Veteran Clinics. Her interests are in cultural competence, social justice, and racial/health equity. Her passion for public health began after she joined Zeta Phi Beta Sorority Inc., a lifelong community conscious action oriented organization. While in THE NY/NJ area she gained experience with policy analysis, data analysis, global public health education, and community outreach. Ndome is now an ORISE Fellow in the Office of the Assistant Secretary for Health's Office of Disease Prevention and Health Promotion's Division of Health Care Quality.”

Joyce Yu

ORISE Health Policy Fellow
USDHHS/OASH/ ODPHP/DHCQ

Joyce Yu received her PharmD from the University of Maryland Baltimore School of Pharmacy in May 2017. Prior to attending pharmacy school, Joyce completed two years of pre-pharmacy studies at the University of Maryland College Park.
Joyce began her career working as a summer intern at the Food and Drug Administration conducting cancer research. Her work in early drug development has led to co-authorship in the February 2014 issue of Cellular Signaling. Throughout pharmacy school, Joyce worked across various settings, including CVS Pharmacy and the Johns Hopkins Hospital. As a student, she was an active member of the American Society of Consultant Pharmacists, Academy of Managed Care Pharmacy, Kappa Psi Pharmaceutical Fraternity, for which she helped to coordinate multiple community outreach events. She now continues to serve as a mentor in the Phi Lambda Sigma Leadership Society for pharmacy students. In addition, Joyce piloted a pharmacy research project in transitions of care to describe multidisciplinary efforts to reduce hospital readmissions, which was published in the September 2017 issue of the Journal of Interprofessional Care. Joyce is passionate about regulatory affairs, health policy, health communication, and new drug approval. She is currently an ORISE Fellow in the Office of Disease Prevention and Health Promotion’s Division of Health Care Quality, and also works per diem as a pharmacist at the Johns Hopkins Hospital Central Pharmacy.

Clydette Powell

Division Director
USDHHS/OASH/ODPHP/DHCQ

Dr Clydette Powell serves as the Director of the Division of Health Care Quality, Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Department of Health and Human Services, Rockville, MD. Her responsibilities include oversight of the federal efforts to advance two National Action Plans: one for the prevention of Health Care Associated Infections and the other for prevention of Adverse Drug Events. Prior to her work at HHS, Dr Powell served as Medical Officer, US Agency for International Development, Washington, DC, for 15 years. Her medical degree was awarded by The Johns Hopkins University School of Medicine and her MPH is from UCLA School of Public Health. Her residencies and fellowship training were at the University of Pittsburgh Medical Centers. She is triple board certified in pediatrics, child neurology, and preventive medicine/public health. She continues to practice clinical medicine part-time at a federally qualified health center for the underserved.