Louisiana Actions to Control Diabetes and Cardiovascular Disease (LA CDCD) will use statewide and regional strategies to increase access to evidence-based programs, improve patient care processes, increase community-clinical linkages, improve patient referral mechanisms, and improve the tracking and use of clinical data to control and reduce the burden of diabetes, heart disease, and stroke in Louisiana’s high-burden populations and statewide.
Well-Ahead Louisiana (WAL) proposes to implement strategies through a tiered approach with mutually reinforcing statewide and regionally targeted strategies. Statewide work focuses on increasing the awareness of prediabetes, diabetes, heart disease, high blood pressure, and high cholesterol among the general population, along with an increased understanding of the risk factors and resources available to prevent the onset of disease. WAL proposes to further focus on provider education and partnership with health systems, payers, and other public health partners to increase the reach and utilization of programs and best practices to improve outcomes related to these diseases. Regionally, WAL has identified four Well-Ahead Chronic Disease Priority Regions where WAL will target individual health systems, providers, and community organizations to launch new programs, establish new referral mechanisms, and conduct quality improvement initiatives.
WAL expects to achieve the following outcomes:
Diabetes Management: 1) Increased access to and coverage for ADA-recognized/AADE-accredited DSMES programs for people with diabetes; 2) Increased use of pharmacist patient care process that promote medication management for people with diabetes; 3) Increased participation in ADA-recognized/AADE-accredited DSMES programs by people with diabetes; and 4) decreased proportion of people with diabetes with an A1C>9.
Type 2 Diabetes Prevention: 1) Increased access to and coverage for the National DPP lifestyle change program for people with prediabetes; 2) Increased community clinical links that facilitate referrals and provide support to enroll and retail participants in the National DPP lifestyle change program; 3) Increased enrollment and retention in CDC-recognized organizations delivering the National DPP lifestyle change program; and 4) Increased number of people with prediabetes enrolled in a CDC-recognized lifestyle change program who have achieved 5-7% weight loss.
Cardiovascular Disease Prevention and Management: 1) Increased reporting, monitoring, and tracking of clinical data for improved identification, management, and treatment of patients with high blood pressure and high blood cholesterol; 2) Increased use of and adherence to evidence-based guidelines and policies related to team-based care for patients with high blood pressure and high blood cholesterol; 3) Increased community clinical links that support systematic referrals, self-management, and lifestyle change for patients with high blood pressure and high blood cholesterol; 4) Increased medication adherence among patients with high blood pressure and high blood cholesterol; 5) Increased engagement in self-management among patients with high blood pressure and high blood cholesterol; 6) Increased participation in evidence-based lifestyle interventions among patients with high blood pressure and high blood cholesterol; and 7) Increased control among adults with known high blood pressure and high blood cholesterol.