Background: As 90% of those with diabetes see primary care, there is opportunity for collaborations to address clinician-level therapeutic inertia. The Diabetes Inertia Collaborative (DIC) is a primary and diabetes specialty care partnership to address lack of time, availability, and increase confidence in clinical recommendations. A diabetes specialty team (endocrinologists, CDCES, RN, RD, NPs) roundtable group reviewed and referred patients to Team-Based Care Pathways (Table 1).
Methods: A prospective pilot QI was conducted at an academic center with a Population Health Accountable Care Organization. Those with A1c >7.0% on the employee health plan were identified through an enterprise data warehouse population health dashboard. Preliminary pre-post evaluation of clinical outcomes (A1c) over six months was conducted for the first 494 participants (N=1065 total) enrolled.
Results: N=494 were mean 54.38 (SD 10.85) years with A1c of 9.4% (1.74) at baseline. Most were White (n=307, 62.1%), non-Hispanic (n=445, 90.1%), and male sex (n=260, 52.6%). Overall, A1c decreased pre-post-intervention (-0.77%, 95% CI [-0.60,-.94]). Multiprogram (-0.55%, CI [-0.11, -0.99]), Pharmacy (-1.01%, CI [-0.61, -1.42]), Milestones (-1.52%, CI [-0.89, -2.14]) and PCP (-0.85%, CI [-0.53, -1.18]) had a significant A1c decrease.
Conclusion: The DIC was well received and adopted by primary care, resulting in program referrals as needed and improved A1c from baseline.
B.Hatipoglu: None. J.E.Blanchette: Advisory Panel; LifeScan Diabetes Institute, Cardinal Health/Edgepark, Provention Bio, Inc., Board Member; JDRF, Consultant; WellDoc, Other Relationship; Tandem Diabetes Care, Inc., Research Support; Association of Diabetes Care & Education Specialists, Speaker's Bureau; Insulet Corporation. R.Ozturk: None. J.Fetzner: None. P.Pronovost: None.
