the national diabetes prevention program updates 2014

22
National Diabetes Prevention Program Ann Albright, PhD, RD Director, Division of Diabetes Translation Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Diabetes Translation www.cdc.gov/diabetes The findings and conclusions in this presentation are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Upload: hpcareernet-llc

Post on 18-Jun-2015

595 views

Category:

Health & Medicine


0 download

DESCRIPTION

A presentation on National DPP training and program recognition.

TRANSCRIPT

Page 1: The National Diabetes Prevention Program Updates 2014

National Diabetes Prevention Program

Ann Albright, PhD, RDDirector, Division of Diabetes Translation

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health Promotion

Division of Diabetes Translation www.cdc.gov/diabetes

The findings and conclusions in this presentation are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Page 2: The National Diabetes Prevention Program Updates 2014

29 million with Diabetes

86 millionwith Prediabetes

Centers for Disease Control and Prevention National Diabetes Statistics Report, 2014

Page 3: The National Diabetes Prevention Program Updates 2014

www.cdc.gov/diabetes

County-level Estimates of Diagnosed Diabetes among Adults Aged ≥20 Years: United States 2004–2010

Percent0 - 6.5

6.6 - 8.0

8.1 - 9.4

9.5 - 11.1

> 11.2

Page 4: The National Diabetes Prevention Program Updates 2014

Current Projections of Cases of Diabetes

in the United States by 2030

2007 2010 2015 2020 2025 20300

10

20

30

40

50

60

70

mill

ion

s

Page 5: The National Diabetes Prevention Program Updates 2014

Economic Cost of Diabetes in US, 2012

Total economic costs, $245 b.

Institutional care $91b. Outpatient care $32 b.

Indirect cost, $69 b.Direct medical cost, $176 b.

Lost workdays, $5 b.Product. loss, $24 b.Disability $22 b.

Mortality, $18 b.

Medications and supplies $53 b.

ADA, Diabetes Care, 2013

Page 6: The National Diabetes Prevention Program Updates 2014

Very High Risk

(A1c > 5.7%; IGT; GDM)

Moderate Risk

Low Risk

High Risk (FPG > 100);

Central Obesity; HTN, age

Risk Stratification Pyramid for Diabetes Prevention

10-year risk (%)

>30 %

>20 %

>10%

>0%

Prevalence (%)

~10 %

~25 %

~65%

Page 7: The National Diabetes Prevention Program Updates 2014

Proportion of U.S. Adults Aged > 20 with Prediabetes

Who Are Aware of Their Risk Status

MMWR, 2013

Page 8: The National Diabetes Prevention Program Updates 2014

Evidence for National Diabetes Prevention Program

• The DPP research study showed that structured lifestyle change program achieved modest weight loss of 5-7 percent and 150 min PA/wk reduced type 2 diabetes by 58% (71% in those over age 60) in those at high risk for type 2 diabetes– True for all participating ethnic groups and for both men and women– Blood pressure and lipids improved– 10-year f/u shows continued reduction in new cases of type 2 diabetes

• Translational studies demonstrate trained lay health workers are as effective in delivering the lifestyle change program as health professionals

• National DPP is 1/3 of the cost of DPP research study and demonstrates similar lifestyle change results

Page 9: The National Diabetes Prevention Program Updates 2014

Cost Effectiveness

• Diabetes prevention lifestyle change programs have been shown to be cost effective and can be cost saving

• Influenced by target population, delivery format and personnel, time horizon

• Some modeled data from an insurer has shown a three year cumulative ROI of 3:1 when using a pay-for-performance approach

Page 10: The National Diabetes Prevention Program Updates 2014

BASIC SCIENCE

EFFICACY

EFFECTIVENESS

EFFICIENCY

AVAILABILITY

DISTRIBUTION

Molecular/ physiological

Molecular/ physiological

Ideal settings

Ideal settings

Real world settings

Real world settings

Biggest effect on most people

Biggest effect on most people

SupplySupply

Diffusion of interventionsDiffusion of

interventions

Adapted from information in Sinclair JC, et al. N Engl J Med. 1981;305:489–494. and Detsky AS, et al. Ann Intern Med. 1990;113:147-154.

Page 11: The National Diabetes Prevention Program Updates 2014

National Center for Chronic Disease Prevention and Health Promotion

Division of Diabetes Translation www.cdc.gov/diabetes

Albright A, Gregg EW. Am J Prev Med. 2013;44(4S4):S346-S351.

Page 12: The National Diabetes Prevention Program Updates 2014

Increase Workforce

• Trained lifestyle coaches attached to delivery organization

• Lay coaches and health professional coaches can both effectively deliver the program

• Use organizations that train to a CDC-approved curriculum

• > 6800 coaches trained

Page 13: The National Diabetes Prevention Program Updates 2014

Quality Assurance

CDC Recognition:• Assure program quality and fidelity to

scientific evidence• Maintain a registry of recognized

organizations• Provide technical assistance to programs to

assist staff in delivery and problem-solving to achieve and maintain recognition

• > 500 sites in recognition program

www.cdc.gov/diabetes/prevention/recognition

Page 14: The National Diabetes Prevention Program Updates 2014

Getting Started: Diabetes Prevention Recognition

Program• CDC recognizes U.S. organizations with programs that are effective in helping participants achieve lifestyle changes that prevent type 2 diabetes among those at risk

• Achieve and maintain recognition by applying for and following the Diabetes Prevention Recognition Program Standards – Participating organizations voluntarily submit program data

to CDC

• Review Diabetes Prevention Recognition Program standards and operating procedures prior to submitting the application

http://www.cdc.gov/diabetes/prevention/recognition

Page 15: The National Diabetes Prevention Program Updates 2014

Diabetes Prevention Recognition Program

www.cdc.gov/diabetes

Application rejected, TA offered

Perform capacity

assessment

Go to DPRP Web

page

CDC reviews

application

Submit session data

every six months

Read DPRP

Standards

Pending recognition status

CDC evaluates

program at 24 months

Review Curriculum

Recruit and begin lifestyle change class

Program is granted full recognition

status

Submitonline form

First session data to CDC

after six months

Recognition evaluated every 24 months

ApplicationReview/Initiate

Maintenance

www.cdc.gov/diabetes/prevention/recognition.htm

Pending recognition status if

not compliant

If using National

DPP Curriculum may consult DTTAC for training

Page 16: The National Diabetes Prevention Program Updates 2014

Recognition Benefits

Quality Assurance associated with recognition can be influential to help you: • enroll participants • obtain health care provider referrals

Recognition may facilitate reimbursement from a growing number of insurers paying for the program

CDC provides technical assistance, including feedback on data submitted

There is no charge to become recognized by CDC

Page 17: The National Diabetes Prevention Program Updates 2014

Recognition Benefits

Program contact information included on CDC web site

http://www.cdc.gov/diabetes/prevention/recognition/registry.htm

Page 18: The National Diabetes Prevention Program Updates 2014

Recognition Benefits: Collective Impact

Recognized programs join the largest national effort, the National Diabetes Prevention Program,

to bring this effective lifestyle change program to communities

Page 19: The National Diabetes Prevention Program Updates 2014

Deliver Program

• Link health care and community sectors• Effective business model for program

scalability and sustainability• Programs in 50 states and DC to date –

need many more• Exploring methods to deliver program

more widely• 5.8% wt. loss with > 4 first phase sessions

and > 1 second phase sessions (maintenance)

Page 20: The National Diabetes Prevention Program Updates 2014

Current National Diabetes Prevention Program Sites

Copyright © 2005-2014 Zee Source. All rights reserved.

20

Source: Diabetes Prevention Recognition Program (CDC/National Diabetes Prevention Program)

Page 21: The National Diabetes Prevention Program Updates 2014

Support Program Uptake

• 89% with no diagnosis and no symptoms requires aggressive awareness and testing efforts

• Engage multiple channels: employers, insurers, providers and directly to consumers

Page 22: The National Diabetes Prevention Program Updates 2014

Summary

– Evidence for prevention through lifestyle change is strong

– Lifestyle change program is cost effective

– A coordinated approach, as provided by the National DPP, is critical to achieve scale

– Quality assurance and evaluation are part of National DPP

– Need to act now and think BIG