701 Pennsylvania Ave. N.W.
Suite 700
Washington, DC 20004
(202) 737-5980
dmaa@dmaa.org
www.dmaa.org

Monday, Sept. 8, 11:30 a.m. - 1:30 p.m.

This study evaluated the effect of one year of lifestyle health coaching on self-reported health status of 3,613 adults with classes I, II or III obesity. At baseline, the transformed scores tended to be highest for participants with class I and lowest for participants with class III obesity. On program completion, all sub-groups experienced significant improvements (p<0.05) for all domains. However, the magnitude of improvement tended to be greatest for participants with class III obesity. This poster will increase awareness of the negative impact of obesity on self-reported health status; document the magnitude of improvement in self-reported health status in obese participants in a lifestyle health coaching program; and evaluate the effect of the severity of obesity on improvements in self-reported health status in response to participation.

Neil F. Gordon, MD, PhD, MPH, chief medical and science officer, Nationwide Better Health (presenter)

Richard D. Salmon, DDS, MBA, vice president, product development, Nationwide Better Health

William E. Saxon Jr., ASRT, consultant, information technology, Nationwide Better Health

Neil F. Gordon, MD, PhD, MPH, is chief medical and science officer for Nationwide Better Health. He was the founder of the INTERVENT lifestyle management programs, and has authored more than 100 published scientific manuscripts and eight books on preventive medicine.

Pregnancy outcome information is used in disease management to evaluate cost-effectiveness of interventions and for research and reporting. Obtaining information from the medical record is both time-consuming and expensive. This study sought to determine the effectiveness of telephone interviews as reliable methodology for collection of pregnancy outcome data. Patient-reported pregnancy outcome data was collected via telephone interview for 285 mothers with 478 neonates and compared with data abstracted from maternal and infants' hospital records. Concordance and/or Kappa coefficients between the medical record and maternal reports were high for delivery date (96.4 percent); birth weight within 100 grams (88.9 percent); Cesarean delivery (99.0 percent, Kappa=0.98) and high-level nursery admission (91.2 percent, Kappa=0.82).Telephone interviews with skilled nurses offer a reliable, cost-effective data collection methodology for key perinatal indicators.

Cheryl N. Desch, BSN, MS, project manager, clinical research, Matria Healthcare Inc. (presenter)

Niki B. Istwan, RN, director, clinical research, Matria Healthcare Inc.

Debbie J. Rhea, MPH, director, clinical data management, Matria Healthcare Inc.

Cheryl Desch, BSN, MS, is a clinical research project manager for Matria Healthcare Inc. She has more than 25 years of nursing experience as a staff nurse, clinical instructor, perinatal nurse and outreach coordinator. She received her bachelor's in nursing from Valdosta State University and her master's from Arizona State University.

This study evaluated the impact of a six-month medication adherence program that used an adherence assessment tool to generate patient-specific strategies. After the initial assessment, participants, who were employees at a large Southeastern public school system, received two telephone contacts to discuss patient-specific barriers and reinforcement education materials. Instruments measuring asthma control and productivity were assessed pre-and post-intervention. Attendees will learn how a medication adherence assessment tool can be used in developing targeted interventions; hear about the level of medication adherence, asthma control and productivity loss in patients with asthma; and understand the needs and the value of targeted medication adherence programs in an employer setting. The intervention will show a positive impact on the level of asthma control, the number of barriers to adherence and self-reported productivity and social activities.

Jinhee Park, MS, MA, manager, GlaxoSmithKline (presenter)

Becky Cherney, president & CEO, Florida Health Care Coalition

James H. Jackson IV, PharmD, MPH, senior director, Xcenda

Karlene Ranghell, MBA, RRT, director, Florida Health Care Coalition

Elizabeth Skinner, PharmD, senior manager, GlaxoSmithKline

Jinhee Park, MS, MA, is a manager at GlaxoSmithKline and responsible for managing a broad range of health outcomes research. She earned a master's in pharmacy administration from the University of Texas and a master's in economics from the University of Southern California (USC). She is completing her doctorate in health economics from USC

In Brazil, quality of life is a growing concern in the management of chronic ill patients. This poster evaluates the impact of a lifestyle change program on quality of life. Patients participated in a group lifestyle change program and a questionnaire developed by the World Health Organization, which was answered before and after the intervention. The questionnaire accessed quality of life with 26 items that reflects the four domains: physical, psychological, social and environment. Learn more about the significant improvement and challenges to quality of life in Brazilian patients with chronic disease.

Andrea Zacouteguy Lage, MD, endocrinologist, TotalCare, Amil Health System (presenter)

Marlene N. Aldin, TotalCare, Amil Health System

C. E. R. Trindade, TotalCare, Amil Health System

Valter Furlan, MD, MBA, manager, TotalCare, Amil Health System

Dino Roberto Gomes, director, TotalCare, Amil Health System

Andrea Zacouteguy Lage, MD, is an endocrinologist with TotalCare, a chronic disease prevention and treatment program of Amil Health System. She has a master's degree in endocrinology from the Federal University of San Paulo.

An understanding of factors that may individually and collectively impact pregnancy outcomes is beneficial in the clinical evaluation of individual patients and can provide justification for clinicians' intervention/surveillance decisions. This investigation sought to determine factors influencing pregnancy outcomes in women with preterm labor and propose a scoring system for identification of patients at highest risk for spontaneous preterm delivery at less than 32 weeks' gestation. The scoring system was created using factors with an odds ratio for cervical dilation >1.9 cm, vaginal bleeding, cerclage, black race and smoking. This poster will describe clinical and financial ramifications of pre-maturity, clinical interventions appropriate for women with preterm labor and maternal factors placing a pregnancy at high-risk for very preterm birth.

Debbie J. Rhea, MPH, senior director, outcomes, Matria Healthcare Inc. (presenter)

Niki B. Istwan, RN, director, clinical research, Matria Healthcare Inc.

Gary J. Stanziano, MD, senior vice president, Matria Healthcare Inc.

Debbie J. Rhea, MPH, is the senior director of outcomes at Matria Healthcare Inc. She has co-authored more than 40 journal articles, 90 abstracts and a book chapter, all examining various associations of risk factors with pregnancy outcomes. She has a master's in public health (epidemiology) from the University of Michigan.

Influenza vaccination is one of the universal recommendations by the Centers for Disease Control and Prevention for a specific cohort of patients, including patients with chronic conditions, children younger than 5 and people 65 and older. This poster presentation will highlight the effect vaccinations have on reducing hospitalization and emergency room visits, identify subgroups of the chronically ill population for whom vaccinations have the greatest impact and illustrate vaccination usage as a primary plausibility indicator in assessing disease management outcomes.

Ravi Iyer, PhD, MBA, senior research analyst, Accordant. A CVS/Caremark Company (presenter)

Jan Berger, MD, Masters, Law, chief clinical officer and senior vice president, CVS/Caremark

Leonard E. Fensterheim, MPH, senior advisor, analytics & outcomes, Accordant, A CVS/Caremark Company

Ravi Iyer, PhD, MBA, is a senior analyst with Accordant, A CVS/Caremark Company. He has a doctorate in pharmacy administration and a master's in business administration in health care from the University of Louisiana. He has presented research at national and international conferences for the International Society of Pharmacoeconomics and Outcomes Research.

Treatment guidelines recommend continuation of antidepressant therapy for at least four to five months post-symptom remission. Premature discontinuation of antidepressants correlates with increased relapse rates. Additionally, complicating the physician's ability to counsel patients regarding adherence, is the fact that patients provide inaccurate reports. Using retrospective pharmacy claims, this study examined longitudinal effectiveness in increasing adherence of a physician-directed, fax-based initiative that included patient-specific adherence rates to antidepressant therapy. Adherence, measured utilizing the medication possession ratio, will be presented.

Katherine S. Thweatt, EdD, senior manager, clinical quality, MemberHealth (presenter)

Alan Pendergrass, PharmD, MBA, manager, analytics & outcomes, MemberHealth

Samuel Rajan, RPh, vice president, clinical operations, MemberHealth

Jackie Y. Raskind, PharmD, BCPS, clinical pharmacist, MemberHealth

Laura Wilson, PharmD, director, clinical operations, MemberHealth

Katherine S. Thweatt, EdD, is the senior manager of clinical quality at MemberHealth, a subsidiary of the Universal American family of companies. Dr. Thweatt earned her doctorate in education from West Virginia University. After a career in teaching, she served as a research scientist in the Veterans Health Administration.

Michigan Medicaid developed a comprehensive assessment of disease and case management programs in contracted health plans, focusing on integration, staffing, stratification, registries and evaluation. Criteria, which were developed collaboratively with Michigan State University's Institute for Health Care Studies and DMAA, included written assessments for each plan, followed by onsite interviews. Pre-assessment and onsite findings were combined and analyzed for each targeted review element. Discover the opportunities to improve coordination of care across the continuum for beneficiaries enrolled in Medicaid disease management programs, best practices and various methods to implement disease management and case management processes to meet health plan accreditation and state oversight requirements.

Susan Moran, MHP, RN, director, Bureau of Medicaid Program Operations & Quality Assurance, Department of Community Health, Medical Services Administration, State of Michigan (presenter)

Debra J. Darling, RN, BSN, project manager, quality improvement, Institute for Health Care Studies, Michigan State University

Stacey A. Duncan-Jackson, MPA, RN, BSN, program director, quality improvement, Institute for Health Care Studies, Michigan State University

Susan Moran, MPH, RN, is the director of the Bureau of Medicaid Program Operations and Quality Assurance for the Michigan Department of Community Health Medical Services Administration. She is responsible for the administration of the Medicaid managed care, customer service and pharmacy programs. Ms. Moran also is responsible for the leadership and direction of Medicaid program performance monitoring and quality improvement initiatives.

This study, designed as an intervention control cohort, aimed to increase the enrollment rate into a telephonic disease management program. The intervention was an invitation to participate in a telephonic disease management program by the participant's primary care physician through verbal and/or written correspondence. The usual care group was invited through written correspondence from the disease management vendor. This poster will describe how to raise awareness and engage a group of primary care physicians, the specific implementation strategies employed and the measurable improvement on contact and enrollment rates.

Sidna M. Tulledge-Scheitel, MD, MPH, medical director, Mayo Clinic Health Solutions, Mayo Clinic (presenter)

Joseph W. Furst, consultant, Department of Family Medicine, Mayo Clinic

Pamela B. Gottlieb, director, disease management, Mayo Clinic Health Solutions, Mayo Clinic

James M. Naessens, consultant, health care policy & research, Mayo Clinic

Kim L. Poe, RN, supervisor, Mayo Clinic Health Solutions, Mayo Clinic

James E. Rohrer, consultant, research, Department of Family Medicine, Mayo Clinic

Sidna Tulledge-Scheitel MD, MPH, is the medical director at Mayo Clinic Health Solutions with the Mayo Clinic. She is an assistant professor and a consultant in primary care internal medicine, health care policy and research for the Mayo Clinic. Dr. Tulledge-Scheitel has received three degrees from the University of Minnesota: a bachelor's in biochemistry, a medical doctorate and a master's in public health.

This poster analyzes a health risk management program in which employees participated in a wellness assessment that included a blood screen and a health history and lifestyle questionnaire. Results were analyzed for eight employer sponsors from 2003 through 2006. On average, employees improved their total health risk score over a 12 month period. They were more likely to reduce LDL and total cholesterol levels after one year than any other biometric measures. Additionally, employees who improved their total score after one year following the initial screening sustain improvement after two years. Learn how to identify the benefits of health risk assessments that include biometric measures and compute total risk scores.

Matthew McGinnis, senior director, Center for Health Research, Healthways Inc. (presenter)

Matthew McGinnis is a senior director and team leader within the Center for Health Research at Healthways Inc. The Center for Health Research gives the health care industry a transparent, peer-reviewed source of scientifically valid conclusions about the drivers of health care outcomes.

All health care systems are challenged to care for patients with chronic conditions; multi-skilled professionals are needed to work with both the patients and their family. This 44-month study highlights a Brazilian disease management program that provided specialized staff for the patient as well as the caregiver, including psychologists and social workers. By improving the patient-caregiver relationship, patient's health improved, including a reduction in emergency room visits, length of stay and frequency. Learn about: the application of this unique program in a primary care setting, the results of a caregiver burden questionnaire and suggestions for improving the patient-caregiver relationships.

Andréa Aparecida Sette, PhD, is a medical manager in private medical service in Brazil. She specializes in the management of patients with chronic conditions and coordinated the first program of caregivers in Brazil's Health Care Network.

The health risk assessment (HRA) is a valuable tool for disease management programs to supplement the traditional method (medical claims analysis) of identifying individuals most at risk for future illness exacerbations and costs. This study features a sample of 1,440 individuals determined to be at risk for diabetes and who completed a Web-based HRA tool that provided a risk score for the individual. The score was based on a proprietary third party vendor algorithm using answers to a battery of health and lifestyle questions. The results indicate a statistically significant relationship (P<.001) between risk score and willingness to change behavior. Hear the key components of an HRA and understand how an HRA could assist developing a plan of action for individual members.

Kennith G. Hunter, DPA, senior biostatistician, HMC (Health Management Corporation) (presenter)

Griselda Chapa, PhD, Director, Client Reporting & Analysis, HMC

Thomas P. Kotsos, BS, Manager, Reporting & Data Analysis, HMC

Kennith G. Hunter, DPA, is a senior biostatistician for HMC. He has worked in the health care industry in research and analytical positions and been published in medical and social science journals on maternity issues, such as socio-economic factors affecting low birth weight and the use of ultrasound to detect genetic abnormalities.

In Denmark, there is an ongoing study to achieve a higher standard of managed care for female cancer patients, with a focus on support. A qualitative study from the patient's perspective on preferences for support following diagnosis of cancer, primary surgery and discharge, is currently being carried out. The results can be used to propose a patient-centered, timely model of support (e.g., a case management model). This poster presented female cancer patients' preferences for support, the future use of the information to improve the standard of care for these patients and ways in which health care researchers and providers can collect rich information directly from patients and use interviews and observation to increase the reliability of information.

Marianne Kirstine Thygesen, MHSC, RN, doctoral student, Gynecological-Obstetric Department, Institute of Clinical Research, University of Southern Denmark (presenter)

Lis Wagner, DrPH, RN, professor, nursing, Institute of Clinical Research, University of Southern Denmark

Birthe D. Pedersen, RN, PhD, MSN, BA, associate professor, nursing, Institute of Clinical Research, University of Southern Denmark

Jakob Kragstrup, DMSC, PhD, professor, Research Unit of General Practice, University of Southern Denmark

Ole Mogensen, DMSC, professor, gynecological-obstetric, Institute of Clinical Research, University of Southern Denmark

Marianne Kirstine Thygesen, MHSC, RN, is a doctoral student at the University of Southern Denmark, Denmark, and has had responsibility for the development of care at Odense University Hospital.

Medicaid managed care members have greater psychosocial needs not directly addressed through traditional medical management. This is especially true for members with HIV/AIDS who often have greater needs for supportive services. An integrated medical management model affords the opportunity to manage medical conditions by encompassing an understanding of how disease and illness are affected by interacting causes and differing levels from the societal to the physical. With a more complete picture of members' needs, positive impacts in member utilization and quality of life have been shown.

Sarah Nasca, MPH, CHES, director, clinical informatics, AMERIGROUP Corp. (presenter)

Sally Dylewski, BSN, MSHSA, CPHQ, vice president, disease management, AMERIGROUP Corp.

Bonnie Burke, MS, associate vice president, clinical informatics, AMERIGROUP Corp.

Sarah Nasca, MPH, CHES, director, clinical informatics, AMERIGROUP Corp.

James Tan, MD, MPH, MBA, senior vice president and national medical director, AMERIGROUP Corp.

Camie Welch, MPH, director, clinical informatics, AMERIGROUP Corp.

Sarah Nasca, MPH, CHES, is director of clinical informatics at AMERIGROUP Corp. and provides analytic support for health promotion, quality management and case management initiatives. She holds a master's in public health and is currently a doctoral candidate in health services research at Old Dominion University.