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Clinical Trial
. 2004 Dec;19(12):1167-74.
doi: 10.1111/j.1525-1497.2004.30425.x.

A practical randomized trial to improve diabetes care

Russell E Glasgow  1 , Paul A Nutting, Diane K King, Candace C Nelson, Gary Cutter, Bridget Gaglio, Alanna Kulchak Rahm, Holly Whitesides, Hilarea Amthauer
Affiliations
Clinical Trial

A practical randomized trial to improve diabetes care

Russell E Glasgow et al. J Gen Intern Med. 2004 Dec.

Abstract

Objective: There is a well-documented gap between diabetes care guidelines and the services received by patients in almost all health care settings. This project reports initial results from a computer-assisted, patient-centered intervention to improve the level of recommended services received by patients from a wide variety of primary care providers.

Design and settings: Eight hundred eighty-six patients with type 2 diabetes under the care of 52 primary care physicians participated in the Diabetes Priority Program. Physicians were stratified and randomized to intervention or control conditions and evaluated on 2 primary outcomes: number of recommended laboratory screenings and recommended patient-centered care activities completed. Secondary outcomes were evaluated using the Problem Areas in Diabetes scale and the Patient Health Questionnaire (PHQ)-9 depression scale, and the RE-AIM framework was used to evaluate potential for dissemination.

Results: The program was well-implemented and significantly improved both number of recommended laboratory assays (3.4 vs 3.1; P <.001) and patient-centered aspects of diabetes care patients received (3.6 vs 3.2; P <.001) compared to those in randomized control practices. Activities that were increased most were foot exams (follow-up rates of 80% vs 52%; P <.003) and nutrition counseling (76% vs 52%; P <.001).

Conclusions: Patients are very willing to participate in a brief computer-assisted intervention that is effective in enhancing quality of diabetes care. Staff in primary care offices can consistently deliver an intervention of this nature, but most physicians were unwilling to participate in this translation research study.

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Figures

FIGURE 1
FIGURE 1
Modified CONSORT. Figure of participant flow.
FIGURE 2
FIGURE 2
Diabetes Priority Program printout goals for the physician.
See this image and copyright information in PMC

Comment in

References

    1. Grant RW, Hamrick HE, Sullivan CM, et al. Impact of population management with direct physician feedback on care of patients with type 2 diabetes. Diabetes Care. 2003;26:2275–80. - PubMed
    1. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA. 2002;288:1775–9. - PubMed
    1. Glasgow RE, Strycker LA. Level of preventive practices for diabetes management: patient, physician, and office correlates in two primary care samples. Am J Prev Med. 2000;19:9–14. - PubMed
    1. Institute of Medicine, Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001.
    1. Solberg LI, Kottke TE, Brekke ML, et al. Failure of a continuous quality improvement intervention to increase the delivery of preventive services. A randomized trial. Eff Clin Pract. 2000;3:105–15. - PubMed

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