Disease management programs: program intervention, behavior modification, and dosage effect

Disease management programs provide highly personalized self- management support to consumers afflicted with chronic illnesses. Program interventions include the provision of health information, ongoing motivation, and support for behavior change, adherence to pharmacotherapy, development of self-efficacy, and the distribution of self-care tools. Interactions between program and patients are structured and repetitive over time. Consumer behavior change can result in measurable improvements in quality and medical cost savings from postponement or avoidance of preventable complications. We evaluated the impact on cost and quality of a comprehensive Diabetes Disease Management Program (DDMP) across ten US urban markets. A staggered implementation allowed for ten pre–post and five pair-wise comparisons. The DDMP demonstrated significant improvements in six diabetes-related quality indicators, lower cost, and a dose-response with greater than 6 months participation. We conclude that a DDMP improves quality of care and reduce overall medical costs.