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Leppin_CDSMP Talk

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Aaron Leppin

This document discusses implementing the chronic disease self-management program in Southeast Minnesota. It summarizes research showing that chronic diseases account for most deaths and healthcare costs in the US. The Stanford Chronic Disease Self-Management Program teaches skills to help people manage chronic conditions. Research shows it improves health outcomes and reduces healthcare utilization. The presenter argues for implementing this program in Southeast Minnesota where needs assessments have identified chronic disease management as a priority, and the regional infrastructure could support program delivery. Next steps discussed are finalizing the community-based participatory research plan and evaluating strategies.

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息2014 MFMER | slide-1 Optimizing Chronic Disease Care in Southeast Minnesota Implementation of the chronic disease self- management program Aaron Leppin, MD Dissemination and Implementation Research Core Knowledge and Evaluation Research Unit; Mayo Clinic
息2014 MFMER | slide-2 Half of all American adults have a chronic disease and prevalence is increasing2 One in four Americans live with multiple chronic conditions2 Chronic diseases account for 80% of all medical care costs in the United States1 Seven out of every ten deaths in the US are the result of chronic disease1 1Kansas Health Institute, 2014; 2Robert Wood Johnson Foundation, 2010;
息2014 MFMER | slide-3 Treatment costs of chronic diseases in Minnesota are estimated at $5 billion annually2 Lost productivity from chronic illness adds $17 billion in costs to Minnesota businesses2 In 2010, chronic diseases accounted for the seven leading causes of death and 57% of potential years of life lost in MN1 In Southeast Minnesota, Community Health and Needs Assessments consistently identify chronic disease management as an area of priority 1Minnesota Center for Health Statistics, 2012; 2Milken Institute, 2007;
息2014 MFMER | slide-4
息2014 MFMER | slide-5 DHHS, AHRQ, and CMS identified four goals: 1. Foster systems change 2. Empower individuals 3. Equip clinicians 4. Enhance research Parekh, JAMA, 2014.
息2014 MFMER | slide-6 The Stanford Chronic Disease Self- Management Program (CDSMP)
息2014 MFMER | slide-7 MIndfulness Dealing with pain Communication strategies Making decisions Problem solving Dealing with emotions Healthy eating Exercising Self-Management Tasks 1. Take care of health condition 2. Carry out normal activities 3. Manage emotional changes1 1Chart 1 from the CDSMP Program Leaders Manual, Stanford University, 2012
息2014 MFMER | slide-8
息2014 MFMER | slide-9 Ive developed a new relationship with my doctors. Im not afraid to ask questionsIm a member of the team. The class helps you live life, not just endure it. I am not so isolated. My health happens between visits, outside the hospital and office. I learned new strategies for keeping depression and pain at bay, ways to relax my mind and body, and eye-opening ideas for exercise that I could do. CDSMP Fact Sheet, National Council on Aging
息2014 MFMER | slide-10 Randomized Trial Outcomes 6 months follow-up: exercise, cognitive symptom management, communication with physicians, self-reported health, distress, fatigue, disability, social/role activities, hospitalizations and days in hospital all improve1 2 years follow-up: reduced health care utilization, improved self-efficacy2 1Lorig, Med Care, 1999; 2Lorig, Med Care, 2001;
息2014 MFMER | slide-11 National observational study Replicated findings among 1170 participants in 22 sites across 17 states 1 year follow-up: self-reported health, depression, fatigue, pain, stress, sleep, communication with physician, medication adherence, health literacy, healthcare utilization all improve1 1Ory, Med Care, 2013;
息2014 MFMER | slide-12 National observational study Net savings of $364 per person1 Potential saving of $6.6 billion by reaching 10% of Americans with one or more chronic conditions2 1Ory, Med Care, 2013; 2Ahn, BMC Public Health, 2013
息2014 MFMER | slide-13 ASMP/CDSMP Meta-Analysis Project Team, Center for Disease Control and Prevention, 2011; at the population level, these interventions could have a considerable public health effect due to the potential scalability of the interventions, the relative low cost to implement them, wide application across various settings and audiences, and the capacity to reach large numbers of people
息2014 MFMER | slide-14 ASMP/CDSMP Meta-Analysis Project Team, Center for Disease Control and Prevention, 2011; As result of findings, executive summary identified several key strategies to move forward: Incorporate CDSMP referral into standards of care, care protocols, and other policies that guide high- quality chronic disease care Invest resources to support wide-scale implementation Encourage CDSMP participation as part of routine care of individuals with chronic disease Research: explore differential effectiveness by participant characteristics
息2014 MFMER | slide-15 Why now?
息2014 MFMER | slide-16 Prepared by Health Promotions and Chronic Disease Division and the Office of Statewide Health Improvement Initiatives; MDH, 2012; No single organization can accomplish the goals and objectives set forth in this framework. But every organization or entity whose mission entails improving the health of Minnesotans should be able to see itself somewhere in this framework.
息2014 MFMER | slide-17 Why here? Rice Houston Dodge Mower Fillmore Goodhue Olmsted Winona Wabasha Steele Freeborn Regional infrastructure to support program implementation, oversight, and participation
息2014 MFMER | slide-18 MCHS Site Elder Network Site
息2014 MFMER | slide-19 How has this been done?
息2014 MFMER | slide-20 Current Status/Next Steps Stakeholders engaged at multiple levels Finalizing protocol and approach to CBPR project Evaluating key strategies and funding opportunities
息2014 MFMER | slide-21 Questions & Discussion leppin.aaron@mayo.edu

More Related Content

Leppin_CDSMP Talk

  • 1. 息2014 MFMER | slide-1 Optimizing Chronic Disease Care in Southeast Minnesota Implementation of the chronic disease self- management program Aaron Leppin, MD Dissemination and Implementation Research Core Knowledge and Evaluation Research Unit; Mayo Clinic
  • 2. 息2014 MFMER | slide-2 Half of all American adults have a chronic disease and prevalence is increasing2 One in four Americans live with multiple chronic conditions2 Chronic diseases account for 80% of all medical care costs in the United States1 Seven out of every ten deaths in the US are the result of chronic disease1 1Kansas Health Institute, 2014; 2Robert Wood Johnson Foundation, 2010;
  • 3. 息2014 MFMER | slide-3 Treatment costs of chronic diseases in Minnesota are estimated at $5 billion annually2 Lost productivity from chronic illness adds $17 billion in costs to Minnesota businesses2 In 2010, chronic diseases accounted for the seven leading causes of death and 57% of potential years of life lost in MN1 In Southeast Minnesota, Community Health and Needs Assessments consistently identify chronic disease management as an area of priority 1Minnesota Center for Health Statistics, 2012; 2Milken Institute, 2007;
  • 4. 息2014 MFMER | slide-4
  • 5. 息2014 MFMER | slide-5 DHHS, AHRQ, and CMS identified four goals: 1. Foster systems change 2. Empower individuals 3. Equip clinicians 4. Enhance research Parekh, JAMA, 2014.
  • 6. 息2014 MFMER | slide-6 The Stanford Chronic Disease Self- Management Program (CDSMP)
  • 7. 息2014 MFMER | slide-7 MIndfulness Dealing with pain Communication strategies Making decisions Problem solving Dealing with emotions Healthy eating Exercising Self-Management Tasks 1. Take care of health condition 2. Carry out normal activities 3. Manage emotional changes1 1Chart 1 from the CDSMP Program Leaders Manual, Stanford University, 2012
  • 8. 息2014 MFMER | slide-8
  • 9. 息2014 MFMER | slide-9 Ive developed a new relationship with my doctors. Im not afraid to ask questionsIm a member of the team. The class helps you live life, not just endure it. I am not so isolated. My health happens between visits, outside the hospital and office. I learned new strategies for keeping depression and pain at bay, ways to relax my mind and body, and eye-opening ideas for exercise that I could do. CDSMP Fact Sheet, National Council on Aging
  • 10. 息2014 MFMER | slide-10 Randomized Trial Outcomes 6 months follow-up: exercise, cognitive symptom management, communication with physicians, self-reported health, distress, fatigue, disability, social/role activities, hospitalizations and days in hospital all improve1 2 years follow-up: reduced health care utilization, improved self-efficacy2 1Lorig, Med Care, 1999; 2Lorig, Med Care, 2001;
  • 11. 息2014 MFMER | slide-11 National observational study Replicated findings among 1170 participants in 22 sites across 17 states 1 year follow-up: self-reported health, depression, fatigue, pain, stress, sleep, communication with physician, medication adherence, health literacy, healthcare utilization all improve1 1Ory, Med Care, 2013;
  • 12. 息2014 MFMER | slide-12 National observational study Net savings of $364 per person1 Potential saving of $6.6 billion by reaching 10% of Americans with one or more chronic conditions2 1Ory, Med Care, 2013; 2Ahn, BMC Public Health, 2013
  • 13. 息2014 MFMER | slide-13 ASMP/CDSMP Meta-Analysis Project Team, Center for Disease Control and Prevention, 2011; at the population level, these interventions could have a considerable public health effect due to the potential scalability of the interventions, the relative low cost to implement them, wide application across various settings and audiences, and the capacity to reach large numbers of people
  • 14. 息2014 MFMER | slide-14 ASMP/CDSMP Meta-Analysis Project Team, Center for Disease Control and Prevention, 2011; As result of findings, executive summary identified several key strategies to move forward: Incorporate CDSMP referral into standards of care, care protocols, and other policies that guide high- quality chronic disease care Invest resources to support wide-scale implementation Encourage CDSMP participation as part of routine care of individuals with chronic disease Research: explore differential effectiveness by participant characteristics
  • 15. 息2014 MFMER | slide-15 Why now?
  • 16. 息2014 MFMER | slide-16 Prepared by Health Promotions and Chronic Disease Division and the Office of Statewide Health Improvement Initiatives; MDH, 2012; No single organization can accomplish the goals and objectives set forth in this framework. But every organization or entity whose mission entails improving the health of Minnesotans should be able to see itself somewhere in this framework.
  • 17. 息2014 MFMER | slide-17 Why here? Rice Houston Dodge Mower Fillmore Goodhue Olmsted Winona Wabasha Steele Freeborn Regional infrastructure to support program implementation, oversight, and participation
  • 18. 息2014 MFMER | slide-18 MCHS Site Elder Network Site
  • 19. 息2014 MFMER | slide-19 How has this been done?
  • 20. 息2014 MFMER | slide-20 Current Status/Next Steps Stakeholders engaged at multiple levels Finalizing protocol and approach to CBPR project Evaluating key strategies and funding opportunities
  • 21. 息2014 MFMER | slide-21 Questions & Discussion leppin.aaron@mayo.edu