Patient and Provider Attitudes in the Healthcare Context

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
NCT00404027
First received: November 22, 2006
Last updated: August 28, 2014
Last verified: August 2014
  Purpose

The purpose of this research study is to assess patient and provider attitudes towards the role that patients should play in medical decision making and self-management. We will examine the degree to which similarity of attitudes held by VA patients being treated for co-morbid diabetes mellitus and hypertension and by their primary care providers is a determinant of patient satisfaction, patient adherence, and adequacy of blood pressure and diabetic control.


Condition
Diabetes Mellitus
Hypertension

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Retrospective
Official Title: Patient and Provider Attitudes in the Healthcare Context

Resource links provided by NLM:


Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • PPOS scores [ Time Frame: Same day as appointment with provider ] [ Designated as safety issue: No ]
    Patient-Practitioner Orientation Scale: degree of symmetry between patient and provider regarding patient-centeredness


Secondary Outcome Measures:
  • Blood pressure [ Time Frame: Same day as appointment with provider ] [ Designated as safety issue: No ]
    Blood pressure measured at time of provider visit

  • Hemoglobin A1c [ Time Frame: Same day as appointment with provider ] [ Designated as safety issue: No ]
    Hemoglobin A1c, to assess glycemic control


Enrollment: 300
Study Start Date: June 2007
Study Completion Date: October 2010
Primary Completion Date: October 2010 (Final data collection date for primary outcome measure)
Groups/Cohorts
Group 1
Veteran primary care patients

Detailed Description:

Previous work has shown that similarities in patients' and providers' beliefs about the role each should play in health care contexts are associated with greater patient satisfaction, greater trust in the provider, and greater treatment adherence. Extending this work by examining the effect of patient-provider attitudinal similarity on patients' diabetic and blood pressure control over an 18 month period is important because management of patients with co-morbid hypertension (HTN) and diabetes (DM) is a costly and clinically challenging task within the VA health system. Self-report questionnaires will be used to assess VA providers' beliefs about their own preferences for patient-provider role orientation in care, whereas interviews will be used to measure veterans' beliefs about their preferences for patient-provider role orientation in their care, satisfaction with their care, and self-reported treatment adherence. Data regarding health services use, prescription refills (a measure of adherence), and 18-month means of blood pressure and hemoglobin A1c will be collected from veterans' medical records. The study represents a critical step toward understanding how patient and provider attitudes toward care might be explicitly assessed and incorporated into the evidence-based health care delivery process to enhance the management of chronic illnesses and overall health among veterans.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

Veteran primary care patients

Criteria

Inclusion Criteria:

Patients enrolled in primary care clinics at the study sites (Iowa City VAMC, Jesse Brown VAMC - Chicago) who are scheduled to be seen by a participating provider in the next three (3) months and have been seen on at least three (3) additional occasions by that same

provider in the prior 24 months. Participating patients must also:

i) have prior diagnoses of both HTN and DM, as documented in VA administrative files;

ii) have an active prescription for an anti-hypertensive medication in the following medication classes: thiazide diuretic, beta blocker, angiotensin converting enzyme (ACE) inhibitor, angiotensin receptor blocker (ARB), calcium channel blocker, or alpha blocker;

iii) have an active prescription for an oral hypoglycemic agent or for an insulin preparation;

iv) be able to provide informed consent;

v) have a home telephone; and

vi) reside in an independent living environment and not in a skilled care facility.

Exclusion Criteria:

i) cognitive impairment;

ii) severe underlying illness, including: metastatic cancer, active treatment for any malignancy (excluding basal and squamous cell skin cancers), end-stage renal disease, cirrhosis, severe chronic obstructive lung disease requiring home oxygen therapy, and congestive

heart failure with a documented left ventricular ejection fraction of less than 35% or a prior echocardiogram denoting "severe" left ventricular dysfunction; and

iii) visits in the prior 18 months to a VA endocrinology, cardiology, or nephrology clinic.

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00404027

Locations
United States, Iowa
VA Medical Center, Iowa City
Iowa City, Iowa, United States, 52246-2208
Sponsors and Collaborators
Investigators
Principal Investigator: Alan J. Christensen, PhD University of Iowa
  More Information

Publications:
Responsible Party: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00404027     History of Changes
Other Study ID Numbers: IIR 04-201
Study First Received: November 22, 2006
Last Updated: August 28, 2014
Health Authority: United States: Federal Government

Additional relevant MeSH terms:
Diabetes Mellitus
Hypertension
Cardiovascular Diseases
Endocrine System Diseases
Glucose Metabolism Disorders
Metabolic Diseases
Vascular Diseases

ClinicalTrials.gov processed this record on October 22, 2014