Interprofessional Training to Improve Diabetes Care: The ReSPECT Trial - Full Text View

Sponsors and Collaborators:	Department of Veterans Affairs Case Western Reserve University The Cleveland Clinic
Information provided by:	Department of Veterans Affairs
ClinicalTrials.gov Identifier:	NCT00854594

Purpose

The investigators study focuses on improving the care of diabetes, a complex chronic illness, by providing important insights into interprofessional training and its potential role in fostering the necessary interdisciplinary management needed for chronic conditions and in addressing the gap between best practice and actual care provided.

Condition	Intervention
Diabetes Mellitus	Behavioral: Role modeling in Shared medical appointments to Promote Establishing Collaborative Teams (ReSPECT)

MedlinePlus related topics: Diabetes

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Prevention, Randomized, Open Label, Parallel Assignment, Efficacy Study
Official Title:	Interprofessional Training for Improving Diabetes Care

Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:

A1c from clinical databases [ Time Frame: 22 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Interprofessional Education Perception Scale [ Time Frame: 22 months ] [ Designated as safety issue: No ]
Provider Abilities Scale - subscale from the MW Clinicians' Network [ Time Frame: 22 months ] [ Designated as safety issue: No ]
Team Climate inventory [ Time Frame: 22 months ] [ Designated as safety issue: No ]
Physician Comfort with Delegation [ Time Frame: 22 months ] [ Designated as safety issue: No ]
Engagement of non-MD professionals from clinical databases [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Number of insulin starts from clinical databases [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Estimated Enrollment:	12669
Study Start Date:	October 2009
Estimated Study Completion Date:	September 2012
Estimated Primary Completion Date:	September 2011 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1: No Intervention Control sites will receive the baseline measures pre and post. These sites will receive traditional diabetes education, which includes teleconsultation.
2: Experimental Intervention sites will receive baseline measures pre and post, but also indepth Shared Medical Appointments (SMA)(The Role modeling in Shared medical appointments to Promote Establishing Collaborative Teams (ReSPECT) intervention) and at 15 months SMA video conferences. At the end of the 18 months the randomly selected patients and providers will be asked to take part in a qualitative interview.	Behavioral: Role modeling in Shared medical appointments to Promote Establishing Collaborative Teams (ReSPECT) The intervention is designed to educate the clinicians at intervention CBOCs by modeling interprofessional team practices during SMAs for DM patients from each CBOC primary care provider's (PCP) patient panel. We hypothesize that this education at intervention CBOCs will improve interprofessional practices and overall quality care delivered to veterans.

Arms

Assigned Interventions

1: No Intervention

Control sites will receive the baseline measures pre and post. These sites will receive traditional diabetes education, which includes teleconsultation.

2: Experimental

Intervention sites will receive baseline measures pre and post, but also indepth Shared Medical Appointments (SMA)(The Role modeling in Shared medical appointments to Promote Establishing Collaborative Teams (ReSPECT) intervention) and at 15 months SMA video conferences. At the end of the 18 months the randomly selected patients and providers will be asked to take part in a qualitative interview.

Behavioral: Role modeling in Shared medical appointments to Promote Establishing Collaborative Teams (ReSPECT)

The intervention is designed to educate the clinicians at intervention CBOCs by modeling interprofessional team practices during SMAs for DM patients from each CBOC primary care provider's (PCP) patient panel. We hypothesize that this education at intervention CBOCs will improve interprofessional practices and overall quality care delivered to veterans.

Detailed Description:

The complexity of diabetes management challenges the acute care-oriented healthcare system. Some experts suggest part of the problem is that the healthcare system fosters a separate silos decision making model. While there is increasing recognition that quality diabetes care is best provided in an interdisciplinary manner, interprofessional training models are limited, as is understanding of the links between interprofessional training, actual practice, and patient outcomes. Advancing our understanding of interprofessional training models is critical because most of the complications associated with diabetes (e.g., amputations, renal failure, strokes) can be prevented or delayed with proper management.

Our objective is to better understand the processes and mechanisms by which interprofessional training impacts on chronic care management (practice patterns) and the ways it translates into improved patient outcomes.

Eligibility

Ages Eligible for Study:	25 Years to 85 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

CLINICIANS
All clinicians in all of Ohio's CBOCs (except for the Georgetown CBOC) will be eligible for the study (all PCPs have patients with DM in their panel of patients).
PATIENTS
All diabetic patients who are seen in Ohio's CBOCs (except for the Georgetown CBOC) will be eligible for the study.

Exclusion Criteria:

CLINICIANS
Any clinician who doesn't have diabetic patients on their panel, who aren't apart of Ohio's CBOC's, or see patients at the Georgetown CBOC will not be eligible to participate.
PATIENTS
Patients who don't have a diagnosis of diabetes, who aren't seen at one of Ohio's CBOC's, or is seen for their medical care at the Georgetown CBOC will not be eligible to participate.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00854594

Contacts

Contact: Laura Clementz, MA	(216) 791-3800 ext 3046	laura.clementz@va.gov
Contact: Michelle L Davidson, MEd BA	(216) 791-3800 ext 4832	Michelle.Davidson@va.gov

Locations

United States, Ohio
Louis Stokes VA Medical Center
Cleveland, Ohio, United States, 44106-3800

Sponsors and Collaborators

Department of Veterans Affairs

Case Western Reserve University

The Cleveland Clinic

Investigators

Principal Investigator:

David C. Aron, MD MS

Louis Stokes VA Medical Center

More Information

No publications provided

Responsible Party:	Department of Veterans Affairs ( Aron, David - Principal Investigator )
Study ID Numbers:	EDU 08-414
Study First Received:	February 27, 2009
Last Updated:	March 4, 2009
ClinicalTrials.gov Identifier:	NCT00854594 History of Changes
Health Authority:	United States: Federal Government

Keywords provided by Department of Veterans Affairs:

Diabetes
Telemedicine
Shared Medical Appointments

Study placed in the following topic categories:

Metabolic Diseases
Diabetes Mellitus
Endocrine System Diseases

Endocrinopathy
Glucose Metabolism Disorders
Metabolic Disorder

Additional relevant MeSH terms:

Metabolic Diseases
Diabetes Mellitus
Endocrine System Diseases
Glucose Metabolism Disorders

ClinicalTrials.gov processed this record on May 06, 2009