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Randomized Controlled Trial
. 2009 Apr;32(4):585-90.
doi: 10.2337/dc08-0944. Epub 2009 Jan 26.

Simulated physician learning intervention to improve safety and quality of diabetes care: a randomized trial

Patrick J O'Connor  1 , Joann M Sperl-Hillen, Paul E Johnson, William A Rush, Stephen E Asche, Pradyumina Dutta, George R Biltz
Affiliations
Randomized Controlled Trial

Simulated physician learning intervention to improve safety and quality of diabetes care: a randomized trial

Patrick J O'Connor et al. Diabetes Care. 2009 Apr.

Abstract

Objective: To assess two physician learning interventions designed to improve safety and quality of diabetes care delivered by primary care physicians (PCPs).

Research design and methods: This group randomized clinical trial included 57 consenting PCPs and their 2,020 eligible adult patients with diabetes. Physicians were randomized to no intervention (group A), a simulated case-based physician learning intervention (group B), or the same simulated case-based learning intervention with physician opinion leader feedback (group C). Dependent variables included A1C values, LDL cholesterol values, pharmacotherapy intensification rates in patients not at clinical goals, and risky prescribing events.

Results: Groups B and C had substantial reductions in risky prescribing of metformin in patients with renal impairment (P = 0.03). Compared with groups A and C, physicians in group B achieved slightly better glycemic control (P = 0.04), but physician intensification of oral glucose-lowering medications was not affected by interventions (P = 0.41). Lipid management improved over time (P < 0.001) but did not differ across study groups (P = 0.67).

Conclusions: A simulated, case-based learning intervention for physicians significantly reduced risky prescribing events and marginally improved glycemic control in actual patients. The addition of opinion leader feedback did not improve the learning intervention. Refinement and further development of this approach is warranted.

Trial registration: ClinicalTrials.gov NCT00262704.

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References

    1. Saaddine JB, Cadwell B, Gregg EW, Engelgau MM, Vinicor F, Imperatore G, Narayan KM: Improvements in diabetes processes of care and intermediate outcomes: United States, 1988–2002. Ann Intern Med 144: 465– 474, 2006 - PubMed
    1. Gurwitz JH, Field TS, Harrold LR, Rothschild J, Debellis K, Seger AC, Cadoret C, Fish LS, Garber L, Kelleher M, Bates DW: Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA 289: 1107– 1116, 2003 - PubMed
    1. Gandhi TK, Weingart SN, Borus J, Seger AC, Peterson J, Burdick E, Seger DL, Shu K, Federico F, Leape LL, Bates DW: Adverse drug events in ambulatory care. N Engl J Med 348: 1556– 1564, 2003 - PubMed
    1. O'Connor PJ, Sperl-Hillen JM, Johnson PE, Rush WA: Identification, Classification, and Frequency of Medical Errors in Outpatient Diabetes Care In InAdvances in Patient Safety: From Research to Implementation Henriksen K, Battles J, Lewin D, Marks E: Eds. Rockville, MD, Agency for Healthcare Research and Quality (AHRQ), p. 369– 380, 2005 - PubMed
    1. Adams KM, Corrigan J: the Institute of Medicine (IOM): Priority Areas for National Action: Transforming Health Care Quality Washington DC, Committee on Identifying Priority Areas for Quality Improvement, Board of Health Services, Institute of Medicine of the National Academies, 2003 - PubMed

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