The Need

In the U.S. population there are 23.6 million people with diabetes and another 57 million with pre-diabetes. Of the 17.9 million diagnosed with diabetes, 3 million people are not treated and another 9 million people are treated but not successfully according to the U.S. Centers for Disease Control (CDC).

Background

The Asheville Project® began in 1996 as an effort by the City of Asheville, North Carolina, a self-insured employer, to provide education and personal oversight for employees with chronic health problems such as diabetes. Through the  Asheville Project, employees with diabetes received intensive education at a local diabetes education center and were then teamed with community-based pharmacists who worked with them and the rest of the health care team to make sure they were using their medications correctly and sticking with their lifestyle changes. Participants soon began experiencing improved A1C levels, lower total health care costs, fewer sick days, and increased satisfaction with their pharmacist’s services. While these types of collaborative care services have also been successfully replicated with other self-insured employers through the APhA Foundation’s  Patient Self-Management Program for Diabetes and  Diabetes Ten City Challenge, this evidence-based practice has not yet specifically targeted disparity populations nor been adapted or incorporated into other care services such as that of 340B settings like Federally Qualified Health Centers and safety net hospitals.

»  The Asheville Project: Long-Term Clinical and Economic Outcomes of a Community Pharmacy Diabetes Care Program- March/April 2003 »  Patient Self Management Program for Diabetes: First-Year Clinical, Humanistic, and Economic Outcomes - March/April 2005 »  Diabetes Ten City Challenge: Final economic and clinical results- May/June 2009

The Project

Project IMPACT: Diabetes,  IMP roving  A merica’s  C ommunities  T ogether  is a national initiative that aims to improve care for patients with diabetes through community-based interdisciplinary teams that include pharmacists. This project intends to scale previous successes such as  The Asheville Project ,  Patient Self Management Program for Diabetes , and the  Diabetes Ten City Challenge   in 25 communities across the United States.  Project IMPACT: Diabetes   will utilize the APhA Foundation’s structure and process modeling that has consistently produced positive clinical, humanistic and economic outcomes in an effort to reach communities that are disproportionately affected by diabetes. Selected communities will have the opportunity to leverage unique stakeholders, existing programs, creative ideas, and other resources to effectively adapt and implement similar models of care that will achieve comparable results. The APhA Foundation will provide communities with tools, resources, guidance and support to facilitate local success.

Objectives

The key objectives of Project IMPACT: Diabetes are to:

» Expand proven community-based models of care to patients who need it the most in communities across the U.S.
» Improve key indicators of diabetes care in selected communities
» Strengthen local models of care by establishing community peer-to-peer networking and mentoring relationships
» Establish a sustainable platform for permanent change by embedding the following guiding principles:

- Identification and support of disproportionate share populations
- Implementation of collaborative care programs engaging pharmacists
- Establishment of continuous quality improvement processes
- Utilization of patient self-management credentialing
- Collection and regular reporting of minimum data sets

Target Population

Project IMPACT: Diabetes focuses on improving the care of patients who are disproportionately affected by diabetes including:

» Geographic areas with a high incidence of diabetes 
» Patients with sub-optimal hemoglobin A1C and other outcomes 
» Patients with limited access to quality diabetes care 
» Communities with socioeconomic challenges and other factors that impact patient access to care.

National Project Partners Advisory Committee

American Pharmacists Association, Center for Health Value Innovation, Giant Food Stores, HHS Office of Women’s Health, National Diabetes Education Program, U.S. Health Resource Services Administration - Pharmacy Services Support Center, Walgreens