SAN DIEGO, June 11 /PRNewswire/ -- Results from a study presented today at the American Diabetes Association’s (ADA) Annual Scientific Sessions demonstrate Hispanic patients with diabetes were more likely to meet ADA Clinical Practice Recommendations in a nurse-directed diabetes management program involving Hispanic community health workers (CHW’s) than under usual clinic care. Study results show an improvement in diabetes process measures, self-management skills and clinical outcomes among Hispanic patients with diabetes enrolled in the Amigos en Salud(TM) (“Friends in Health”) program. The program uses trained lay CHWs to provide a comprehensive health education intervention developed by Pfizer Health Solutions Inc (PHS).
Eliminating health disparities has specific implications for the approximately two million Hispanic Americans suffering from diabetes. The ADA standards of care recommend diagnostic and therapeutic actions to positively affect diabetes measures such as glycemic control and lifestyle modification.
The Amigos en Salud research study was integrated with a nurse-directed diabetes management program (Diabetes Managed Care Program) and showed improvement in clinical, behavioral and mental health outcomes among Hispanic patients with diabetes. The CHWs, or “promotores,” worked with a clinical diabetes nurse and diabetologist to provide culturally appropriate education to patients with diabetes and comorbid depression. Other responsibilities included conducting patient follow-up, facilitating classes and support groups, working with family members and helping connect patients to the health care system and community resources.
“Community health worker models support, not replace, physician- and nurse-directed diabetes care by providing follow-up and social support to patients, helping them overcome cultural, language or behavioral barriers to treatment,” said Mayer B. Davidson, MD, Professor of Medicine at Charles R. Drew University of Medicine and Science. “Amigos en Salud validates the concept that Hispanic diabetes patients who learn how to manage their disease and adopt a healthier lifestyle can achieve improved clinical outcomes.”
The established Diabetes Managed Care Program (DMCP) developed by Dr. Davidson was implemented within the Los Angeles County Department of Health Services to address the local health disparity issues, where approximately 16 percent of Hispanics have diabetes, almost two times higher than their non- Hispanic white counterparts. The DMCP uses treatment protocols for nurses to clinically manage patients with diabetes and is based on the ADA standards of care.
Study Results
A total of 109 adult Hispanic patients with type 2 diabetes were enrolled into the research study and monitored for 12 months. After one year, participants achieved lower mean A1c levels (9.6 percent to 6.9 percent, p<0.00001) with 60 percent achieving the ADA recommended goal of <7.0 percent (p<0.00001) and lowered LDL cholesterol (126 mg/dL to 82 mg/dL, p<0.00001) with 83 percent meeting the goal of <100 mg/dL (p<0.00001). Self reported behavioral improvements were also noted in healthy eating (54 percent to 92 percent, p<0.0001) and regular physical activity (52 percent to 84 percent, p<0.0001) with 55 percent reporting cardiovascular physical activity levels (p<0.0001) and improvement in self-reported medication adherence (p<0.01).
“Amigos en Salud is a unique example of how an individualized diabetes management approach combined with a mental health focus can help overcome the growing health disparities in the Hispanic community, and as a result, improve both access to and outcomes of diabetes care,” said Ken Babamoto, PharmD, MPH, Director, Community Health Initiatives for Pfizer Health Solutions. “The Los Angeles data supports outcomes from similar Amigos en Salud studies that demonstrate the role of CHWs in improving how diabetes care is currently being delivered to underserved patients.”
Patients who qualified for the study were also screened for depression, which is a very common yet not often recognized disease in the Hispanic community, particularly in those with diabetes. Self-reported depression severity score using the Patient Health Questionnaire (PHQ-9) decreased from 8.3 at baseline to 4.9 (p<0.001) at follow-up. Individuals meeting diagnostic criteria for major depressive syndrome decreased from 21 percent to 12 percent (p<0.01). Results also reported that those with lower depression severity were more likely to have improved physical activity levels, medication adherence and healthy nutrition behaviors.
About Amigos en Salud
Amigos en Salud, which translates to “Friends in Health,” is a culturally appropriate diabetes and depression management program that addresses Hispanic cultural perceptions and lifestyles. The Amigos en Salud program is designed to help Hispanic patients with diabetes and comorbid depression understand their condition, encourage and sustain behavior change, support development of self-management skills, and provide ongoing community support -- in the context of the Hispanic culture.
The program uses trained bilingual CHWs, or promotores, working collaboratively with health care practitioners to provide individual and group health education sessions to support Hispanic patients with diabetes. The CHWs also work directly with patients to develop and implement culturally relevant behavior change strategies, using bilingual education materials at the appropriate literacy level.
The Amigos program, developed by Pfizer Health Solutions, has been implemented in multiple communities throughout the United States: Laredo and Brownsville, Texas; Los Angeles, California; Hartford, Connecticut; and Jersey City, New Jersey.
About Pfizer Health Solutions
Pfizer Health Solutions, the wholly-owned care management subsidiary of Pfizer, partners with health care and community organizations to implement patient-centered programs that focus on prevention, disease management and care coordination to improve patient health and efficiency of health care delivery. To learn more, visit http://pfizerhealthsolutions.com.
About Charles R. Drew University of Medicine and Science
Founded in 1966 in response to the lack of adequate medical facilities in the South Los Angeles area, Charles R. Drew University of Medicine and Science is the only historically Black and Hispanic serving institution for graduate medical and health professions education west of the Mississippi. A private, not-for-profit institution, the University’s mission is to conduct education and research in the context of community service in order to train physicians and allied health professionals to provide care with excellence and compassion, especially to underserved populations. More information about the University is available at http://www.cdrewu.edu.
Pfizer Health Solutions
CONTACT: Amy Delmore of Pfizer Health Solutions, office, +1-212-733-0248,or cell, +1-917-647-5255; or Chad Hyett of Fleishman-Hillard, Inc., office,+1-212-453-2493, cell, +1-917-204-7917