Summaries of Independent Scientist (K) Awards

Parchman, Michael

Institution: University of Texas Health Science Center
Grant Title:  Diabetes Quality of Care in the Primary Care Setting
Grant Number: K08 HS013008
Duration: 4 years (2002-2006)
Total Award: $474,500

Project Description: This project has three main goals:

1. To describe the facilitators and barriers experienced by large health care organization when implementing clinical practice guidelines, including diabetes guidelines within the primary care setting.
2. To assess the relationship between specific structures and processes of care and the quality of diabetes care within 20 primary care practices.
3. To describe how primary care providers prioritize among competing clinical practice guidelines during encounters with diabetic patients with multiple chronic conditions.

Career Goals: Dr. Parchman is an Associate Professor at the University of Texas, Health Sciences Center wants to become and independent investigator and expert in rigorous and innovative diabetes prevention and control research within primary care settings that will have an impact on health care policy and practice. Through an multidisciplinary program of mentoring, training and research, Dr. Parchman, specifically, wants to become an expert in content and methods specific to the conduct of research on the quality of diabetes care in primary care practice-based research networks; and to use these skills to understand the structures and processes of primary care with the goal of improving the quality of diabetes care in a way that pragmatic for primary care practices.

Progress to Date: Data collection has been completed on all three projects. Results have been presented at the Annual Scientific Session of the American Diabetes Association (2004 & 2005) and the North American Primary Care Research Group (2004 & 2005). One manuscript was published in the journal Medical Care in November 2005. A second manuscript was published in the Annals of Family Medicine in Jan-Feb 2006. A third manuscript is in press at the Joint Commission Journal on Quality and Patient Safety, and another has recently been submitted to Diabetes Care. The competing demand and the quality of diabetes care in primary care study provided crucial preliminary study results for a recently funded R34 Planning Grant, "Diabetes and Cardiovascular Risks," from the National Institute of Diabetes, Digestive and Kidney Disorders (NIDDK) on which Dr. Parchman is the Principal Investigator. This study is currently in progress and a subsequent R18 Translational research grant proposal for a large cluster randomized controlled trial has been submitted to the NIDDK.

Future Plans: Abstracts of results from the competing demands study have been accepted for a podium presentation and a poster presentation at the Academy Health Annual Meeting in June 2006 and for publication in the proceedings of the Annual Scientific Session of the American Diabetes Association in June 2006. The R18 Translational Research grant proposal received a favorable score on first review by the study section and a revision will be submitted to the NIDDK in June 2005.

An R18 Translational Research grant proposal will be submitted to the NIDDK on October 1, 2005, for a study of a primary care practice intervention to improve cardiovascular risk factor levels among patients with type 2 diabetes.

Highlights and Specific Accomplishments:

• Professional Societies:
  • American Diabetes Association.
  • Academy Health.
  • North American Primary Care Research Group.
  • Society of Teachers in Family Medicine.
  • American Academy of Family Physicians.

K Generated Publications:

• Parchman ML, Noel PH. Primary Care Attributes, Health Care Systems Hassles, and Chronic Illness. Medical Care 2005 (in press).
• Parchman ML, Burge SK. The Patient-Physician Relationship, Primary Care Attributes and Preventive Services. Family Medicine 2004;26:22-27.
• Wen LK, Parchman ML, Linn W. Self-monitoring of Blood Glucose Among Veterans with Diabetes Managed on Oral Therapy. American Journal of Health-System Pharmacy 2004;61:2401-5.
• Wen LK, Shepherd MD, Parchman ML. Family Support, Diet, and Exercise Among Older Mexican Americans with Type 2 Diabetes. Diabetes Educator 2004;30(6):980-93.
• Wen LK, Parchman ML, Shepherd MD. Family Support and Diet Barriers Among Older Hispanic Adults with Type 2 Diabetes. Family Medicine 2004;36(6):423-30.

AHRQ Research Portfolio: Care Management; Quality and Patient Safety; Training.
AHRQ Goals: Efficiency

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