Automated Diabetes Registry Tools to Enhance Patient Self-Management and Provider Performance Feedback

NCT ID: NCT00827710

Last Updated: 2012-05-01

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 5457 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2007-12-31
• Study Completion Date: 2009-05-31

Brief Summary

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?

Detailed Description

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.

Conditions

Diabetes

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

1

patients who received point-of-care report cards and were listed on provider performance report card

Group Type: ACTIVE_COMPARATOR

point of care patient report cards

Intervention Type: BEHAVIORAL

gives patient feedback on performance on glycemic, lipid, and blood pressure control relative to expert recommended goals

Provider performance report card

Intervention Type: BEHAVIORAL

Gives provider feedback on performance on their diabetes panel of patients and includes patient level data

2

Patients who received point-of-care diabetes report cards but were not listed on provider performance report card

Group Type: ACTIVE_COMPARATOR

point of care patient report cards

Intervention Type: BEHAVIORAL

gives patient feedback on performance on glycemic, lipid, and blood pressure control relative to expert recommended goals

3

Patients who did not receive point-of-care report card but who were listed on provider performance report card

Group Type: ACTIVE_COMPARATOR

Provider performance report card

Intervention Type: BEHAVIORAL

Gives provider feedback on performance on their diabetes panel of patients and includes patient level data

4

Patients who did not receive point of care report card and who did were not listed on provider performance report card

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

point of care patient report cards

gives patient feedback on performance on glycemic, lipid, and blood pressure control relative to expert recommended goals

Intervention Type: BEHAVIORAL

Provider performance report card

Gives provider feedback on performance on their diabetes panel of patients and includes patient level data

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• icd9 code for diabetes
• primary care visit in the past 18 months
• English or Spanish as primary language

Exclusion Criteria

• age more than 75
• No working address

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role: collaborator

Denver Health and Hospital Authority

OTHER

Sponsor Role: lead

Responsible Party

Henry Fischer

MD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

henry h fischer, md

Role: PRINCIPAL_INVESTIGATOR

Denver Health and Hospital Authority

Locations

Denver Health Medical Center

Denver, Colorado, United States

Countries

United States

References

Fischer HH, Eisert SL, Durfee MJ, Moore SL, Steele AW, McCullen K, Anderson K, Penny L, Mackenzie TD. The impact of tailored diabetes registry report cards on measures of disease control: a nested randomized trial. BMC Med Inform Decis Mak. 2011 Feb 17;11:12. doi: 10.1186/1472-6947-11-12.

Reference Type: DERIVED

PMID: 21329495 (View on PubMed)

Other Identifiers

AHRQ Contract 290-2006-000-20

Identifier Type: -

Identifier Source: secondary_id

AHRQ 290-2006-000-20

Identifier Type: -

Identifier Source: org_study_id