"Fatalism can play a major role in community health like, 'Oh, yeah, my family has diabetes. I'm going to get it eventually,'" said Dr Adam Baus, a research assistant professor in the Department of Social and Behavioral Sciences, who led the study. "But that doesn't have to be the case. Not at all."
Baus and his colleagues analyzed data from West Virginia Health Connection, a new online network of clinical and community-based partners working together to prevent and control chronic diseases in the state. The study results were featured in the paper, ‘Informatics-Supported Diabetes Prevention Programming in West Virginia’, published in Perspectives in Health Information Management, West Virginia Health Connection is a collaborative effort between the West Virginia Bureau for Public Health's Division of Health Promotion and Chronic Disease and the WVU School of Public Health's Office of Health Services Research. West Virginia has the US' second-highest rate of diabetes among adults, at 15%. As of 2018, another 11% of adults were diagnosed as pre-diabetic, and still more remain undiagnosed.
The data encompassed 320 individuals who had completed the National Diabetes Prevention Program.
Using the Centers for Disease Control and Prevention's Diabetes Impact Tool, the researchers analysed the data for demographic information; weight, height and BMI; and return-on-investment indicators, including diabetes incidence, medical costs and QALYS. And it's especially important in West Virginia, which has the nation's second-highest rate of diabetes among adults, at 15%. As of 2018, another 11% of adults were diagnosed as pre-diabetic, and still more remain undiagnosed.
They found that participating in the programme caused an increase of 0.2 QALYS after one year, with projected increases of 1.1 QALYS after three years and 4.4 QALYS after ten years.
At the start of programming, 80.3% of participants had obesity, 19.4% were overweight and only 0.3% had a normal weight. By the end of programming, on average participants had lost 13.6 pounds or 6.3% of their total body weight. Projecting three years out, this represents a 32.4 percent overall risk reduction for developing diabetes.
"It's really important for our community partners to be able to have a good, reliable analytic system that they can use to document the programming that they're providing and to be able to demonstrate the effectiveness of their program," said Baus, who directs the WVU Office of Health Services Research. "That's challenging for a lot of people in the community who might not be accustomed to tracking data. They need a good, secure way of doing that and some backbone support so that they can analyse their data and show their program's impact. It's really important for the longevity of their program.
Baus and his colleagues also discovered that the programme was associated with a US$120 decrease in annual medical costs per participant. After three years of participation, annual savings amount to US$341 per person and after ten years, US$989.
By year three, the net cost to run the programme falls to US$50 per person. Projecting the costs over ten years, the programming generates enough healthcare savings that it more than offsets the cost of running the programme itself.
"There's some frustration historically among providers who know their patients could benefit from extra support through prevention programs like this but do not have an easy mechanism to make the referrals, know that patients are attending classes and know what the outcomes are over time," Baus said.
West Virginia Health Connection addresses this need by essentially putting all diabetes-prevention programming in the state under one roof, connecting primary care physicians and specialists to community-based health leaders providing this needed programming.
"It's a secure registry for health information to be collected and analysed so that clinicians can document the care that they're providing and get reports on those data," Baus said. "It's really important for our community partners to be able to have a good, reliable analytics system that they can use to document the programming that they're providing and demonstrate the effectiveness of their efforts. Our state has significant public health burden with prediabetes and diabetes, but we also have amazing, committed partners working to reverse that trend. Working together, we can do this."