NIC = Management rTDISCLAIMER: The information contained in thie annotated biblograpty was cblained tram the putteatons listed The National Pharmaosuiical Counc (NPC) has worked fo ensure that the annotations accurataly react th omarion contained in the publi calions, but cannot guarantee the accuracy of te annctations or te publications. Thara are ares avaatie on the treatment of asthma thal are not included in this biography and that may include relevant information not covered herein. The inclusion of any publican inthis bibiography dose not consiute an endorsement of at publication by NPC or an endorsement ofthe esrvices, Programs, treatments, oF other information contained in such publication ‘This biblicgrapy is designed for informational purposes only, and should not be construed as professional advice on any specific st of fats and circumstances. This ibiograsy ie net intended to be a comprehensive soures of diasaee management eervcee lor programs n the trealment of asthma, ora svbstiue for informed medial advos, If medical ack or ater expert assistance is ‘required readers are urged to consul a qualfed health care provider ar ahr professional. NPC is nct responsi for any elas ‘or losses that may arise from any errors or omigelons inthe inlormaton contained in bis biblegraphy or i the listed pubseatone, whether caused by NPC or ofgiating in any ofthe listed pubsications or any reliance thereon, whether in a cinical or other set tng ‘@August 2004 Natonal Pharmaceutical Counc IncDisease Management for Asthma Introduction Faced with rising heath care costs and Iinited resources, heath care providers continually seek new ways to provide high-quallty, cost-efficient caro? Years ago, eseaso management emerged as a strategy with the potential to factiove this goal? The Boston Consulting Group frst used the phrase “disease management” ins current sense fn a 1998 report. Since thal time, disease management prograrns, techniques, and models have been designed by ‘the pharmaceutical industry, managed care, pharmacy bereft management (PEM) plans, and most recently by state Mectceid prograrns.\+# The Disease Management Association of America defines fsease management sa systein of coordinated healt care interventions aed communications for populations with ‘contions in which pation solf-car offorts aro signiticant.® Disease management supports the ciniclan patient relationship and plan of care, and emphasizes prevention of lsease-rolated exacerbations and complications using cerdence-based practice guidsines endl patient looks Diseaso management aso evaluates i, and economic autcomes on an angeing basis withthe goal of improving overall health The more specific goals of disease managernent inclu" + Improving patient self-care through patient education, monitorng, and cornmunication with members of the health care team. ‘+ Improving physician performance through feedback and/or reports on palient progress in compliance with protocol. ‘+ Improving communication and coordination of services between patient, physician, disease ‘management organization, and othor providers. ‘Improving access to services, Including prevention services and presoription drugs as needed. ‘The fallowing functions are the rain components of kfsease managernent! + Identiioation of paiont popelations. + Use of evidlenoe-based practice guidlines, ‘+ Support of adherence to evidence-based medical practice guidelines by providing practioe guidatines to pysicians and other providers, reporting on the patient's progress in compilance with protocols, and providing support services to assist the plhysician in moritoring the patient. «+ Provision of senoes designed to enhance patient sal management and acherence to the patients Ireaiment plan. + Routine reporting and feedback to the health care Frovidors and to the patient, + Communication and colaboration among providers and between the patient and the patient's providers. * Collection and analyss of process and autcomes rneasures along with a system to make necessary ‘changes based on the findings ofthe process andt ‘oulcomes measures, Disease management programs are used widely for many ‘chronic ciseasce, but the most commnen diseases inetide asthma, congestive hear falure, diabetes melts, and hhyperiension. Consideralions in salecing a disease for isoave management often includes + Avallaily of reatrnent guidelines wth consensus about ‘what constitutes appropriate and effective care ‘+ Prosenco of cenerally recognized problems in therapy thal aro well documented in the snedical iterate. * Large practice variation and a range of drug treatment modaltios. + Large number of patients with the disease whose: therapy could be inyproved. * Proventable acute events that often aro associated with the chronic disease (20. emergency department or Lurgent-oare visits, * Outcomes that can be defined and measured in stenclerlized and objective ways ane! thal can be modified ty application of appropriate therapy (0.0. docreasod number of emergency dopartment visits or hospitalizations) «The potential for cost savings within a short period (e.0, less than years), Three major not-for profit organizations whose mission fs to promote quality health care have recognized the ‘contribution of disease management activities to qualy health cara by establishing disease managernent certification, (oF accreditation programs, The Joint Commission on Accreditation of Healthcare Organizations, an independent, not-for profit organization and the nation's predominant standerds-seting and acoredting body in health care, offers isease-speciic care program ceriicalion." Program ceriication is based on an assessment of compliance with consensus-based nalional stands, elective use of established chica practice guidelines to manage and optimize care, and cities for periormance measurement ‘and improvement ‘The National Committee for Qualty Assurance accredis disease management programs on the basis of standards euysy 40y wawabeuEy 9509510