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| Sponsors and Collaborators: |
Denver Health and Hospital Authority Agency for Healthcare Research and Quality (AHRQ) |
|---|---|
| Information provided by: | Denver Health and Hospital Authority |
| ClinicalTrials.gov Identifier: | NCT00827710 |
Purpose
Can we improve diabetes outcomes through 1) report card mailings to patients 2) point of care distribution of report cards to patients and 3) provider performance feedback with patient level data?
| Condition | Intervention |
|---|---|
|
Diabetes |
Behavioral: point of care patient report cards Behavioral: Provider performance report card |
| Study Type: | Interventional |
| Study Design: | Health Services Research, Randomized, Open Label, Active Control, Factorial Assignment |
| Enrollment: | 5457 |
| Study Start Date: | December 2007 |
| Estimated Study Completion Date: | May 2009 |
| Primary Completion Date: | January 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
1: Active Comparator
patients who received point-of-care report cards and were listed on provider performance report card
|
Behavioral: point of care patient report cards
gives patient feedback on performance on glycemic, lipid, and blood pressure control relative to expert recommended goals
Behavioral: Provider performance report card
Gives provider feedback on performance on their diabetes panel of patients and includes patient level data
|
|
2: Active Comparator
Patients who received point-of-care diabetes report cards but were not listed on provider performance report card
|
Behavioral: point of care patient report cards
gives patient feedback on performance on glycemic, lipid, and blood pressure control relative to expert recommended goals
|
|
3: Active Comparator
Patients who did not receive point-of-care report card but who were listed on provider performance report card
|
Behavioral: Provider performance report card
Gives provider feedback on performance on their diabetes panel of patients and includes patient level data
|
|
4: No Intervention
Patients who did not receive point of care report card and who did were not listed on provider performance report card
|
Our federally qualified health care center serves over 7000 diabetic patients, many of whom are uninsured (43%) or on medicaid (18%) or medicare (26%). The population is 54% Latino, 25% Caucasian, and 14% African American. We excluded patients older than 75; those without English or Spanish as a first language; and the homeless. The remaining 5457 patients were randomized to this one-year study which ended January 1, 2009. One-half of the enrolled patients received quarterly mailed report cards on their HgA1c, blood pressure, and lipid performance.
They were asked to pick from a list of self-management goals and to see their provider if their last visit was more than 2 months prior to the mailing. In a 2x2 design, our eight clinics were randomized to i) on-site printing of patient report cards or no on-site printing and ii) standard provider performance report cards or enhanced provider report cards. The standard provider report cards included data on provider performance on HgA1c, LDL, and blood pressure compared to other providers. The enhanced provider report card also included a list of up to 10 patients not at HgA1c, LDL, or blood pressure goal. The provider report cards were distributed on a quarterly basis, and the point of care patient report cards were distributed at every clinic visit.
We are analyzing the impact of the intervention on the percent of patients at expert recommended goals for glycemic, lipid, and blood pressure control. We are also performing a qualitative analysis to describe provider and patient attitudes toward the interventions.
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contacts and Locations| United States, Colorado | |
| Denver Health Medical Center | |
| denver, Colorado, United States, 80204 | |
| Principal Investigator: | henry h fischer, md | Denver Health and Hospital Authority |
More Information
| Responsible Party: | Denver Health and Hospital Authority ( Henry Fischer ) |
| Study ID Numbers: | AHRQ 290-2006-000-20, AHRQ Contract 290-2006-000-20 |
| Study First Received: | January 14, 2009 |
| Last Updated: | January 21, 2009 |
| ClinicalTrials.gov Identifier: | NCT00827710 History of Changes |
| Health Authority: | United States: Institutional Review Board |
|
diabetes registry computer self management |
|
Metabolic Diseases Diabetes Mellitus Endocrine System Diseases |
Endocrinopathy Glucose Metabolism Disorders Metabolic Disorder |
|
Metabolic Diseases Diabetes Mellitus Endocrine System Diseases Glucose Metabolism Disorders |
