Optimizing Patient Outcomes in Diabetes through Pharmacy and Population Health Strategies: A Comprehensive Review of Medication Adherence and Patient Education in UPMC Health Plan

Abstract

Diabetes, an escalating global health challenge, commands public attention constantly due to its multifaceted impact on individuals and communities. The prevalence of diabetes, particularly type 2 diabetes (T2DM), has reached epidemic proportions, affecting approximately 463 million adults globally in 2019, and is projected to rise to 700 million by 2045. The complex nature of these complications not only compromises the quality of life for individuals with diabetes but also places a substantial burden on our healthcare systems. This essay delves into the intricate interplay between pharmacy and population health strategies within the UPMC Health Plan, offering a comprehensive analysis focused on the various methods for enhancing patient outcomes in diabetes management. Within the UPMC Health Plan, the pharmacy and population health teams aimed to start from multiple angles to optimize patient outcomes in diabetes management. The Pharmacy Team employs various tactics to enhance medication adherence, including IVR/SMS/live calls, analytic capabilities, and CMS STARS diabetes-related strategies. Additionally, interventions focus on planning all-cause readmissions with meticulous post-discharge medication reconciliation and outreach initiatives. Conversely, the Population Health Team's approach incorporates technology-driven interventions like Targeted Automatic eConsults (TACos), CDCES referral services, and Optimization target populations. While pharmacy interventions emphasize metrics aligning with patient compliance and prescribed medication regimens, the Population Health Team adopts a holistic approach to improve clinical outcomes and quality of life through self-management education. This essay comprehensively explores differences between the pharmacy and population health strategies, providing insights into the dynamic synergy required to address the multifaceted challenges of diabetes within the UPMC Health Plan. In addition, the essay will provide recommendations to refine these integrated strategies further and include more perspectives on population health management to form a comprehensive framework for healthcare executives to consider