Improved Delivery of Cardiovascular Care Through Outreach Facilitation (IDOCC)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified December 2007 by C. T. Lamont Primary Care Research Centre.
Recruitment status was  Recruiting
Sponsor:
Collaborators:
Dept of Family Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel
Institute of Population Health, University of Ottawa
University of Ottawa Heart Institute
Ottawa Cardiovascular Centre
Ottawa Regional Stroke Program
Bruyere Research Institute
Champlain Primary Care Practices
Information provided by:
C. T. Lamont Primary Care Research Centre
ClinicalTrials.gov Identifier:
NCT00574808
First received: December 14, 2007
Last updated: NA
Last verified: December 2007
History: No changes posted
  Purpose

The aim of the proposed study is to implement and evaluate Outreach Facilitation as a means to increase the uptake of evidence-based practice for secondary prevention and management of patients with established CVD and cardiovascular risk factors, in primary care practices throughout the Champlain LHIN. This initiative centers on the use of an Outreach Facilitation Model, in which skilled health professionals known as facilitators (Practice Change Consultants) serve as an expert resource to primary care practices in three areas: a) practice performance assessment, feedback, and consensus building towards goal setting and implementation; b) clinical, technical, organizational resources and practical advice; and c) encouragement to face and move through the challenges associated with implementing system change.


Condition Intervention Phase
Hypertension
Dyslipidemia
Diabetes
Chronic Kidney Disease
Cardiovascular Disease
Stroke
Transient Ischemic Attacks
Other: Outreach Facilitation implementing elements of the Chronic Care Model
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Improved Delivery of Cardiovascular Preventive Care (IDOCC) Through Outreach Facilitation

Resource links provided by NLM:


Further study details as provided by C. T. Lamont Primary Care Research Centre:

Primary Outcome Measures:
  • Quality of care process index = ∑ of recommended services received by patient/ ∑ of the recommended services for which the patient was eligible [ Time Frame: 5 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Quality of care outcome index = ∑ of recommended targets reached / ∑ of the number of targets for which the patient is eligible based on the number of conditions suffered by the patient [ Time Frame: 5 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 210
Study Start Date: April 2007
Estimated Study Completion Date: April 2012
Arms Assigned Interventions
Experimental: intervention
Outreach Facilitation implementing elements of the Chronic Care Model. The facilitators will provide hands on support to practices and help to implement tools and processes designed to incorporate evidence-based practice into the routine delivery of cardiovascular care. Specifically, they will a) assist with practice performance assessment, feedback, and consensus building towards goal setting, b) offer clinical, technical, organizational resources and practical advice, and c) provide encouragement to face and overcome the challenges of implementing system change.
Other: Outreach Facilitation implementing elements of the Chronic Care Model
An outreach facilitator helps the practice identify areas for improvement, set goals and targets, and agree on the processes needed to reach them in order to improve the care delivery within the practices. Each facilitator will be assigned up to 12 practice sites. The first year of program implementation will involve frequent (once every 3-4 weeks) visits to the practices. Afterwards, the intervention will move into a sustainability mode, during which the frequency of visits will decrease to one every 6-8 weeks during the second year, and one every 12-15 weeks during the third year and thereafter. After the first year of program implementation, each facilitator will be able to take on 12 new practices during the second year, while still being able to sustain contact with the previous 12 practices. Similarly, in the third year, another set of 12 practices will begin the "intense" phase of program implementation.
No Intervention: control
Baseline data before implementation of the program will serve as the control. Comparisons will be made between baseline and post-intervention within each divisions of primary care practices as well as between divisions (ie. baseline information from one division will serve as the control for another).
Other: Outreach Facilitation implementing elements of the Chronic Care Model
An outreach facilitator helps the practice identify areas for improvement, set goals and targets, and agree on the processes needed to reach them in order to improve the care delivery within the practices. Each facilitator will be assigned up to 12 practice sites. The first year of program implementation will involve frequent (once every 3-4 weeks) visits to the practices. Afterwards, the intervention will move into a sustainability mode, during which the frequency of visits will decrease to one every 6-8 weeks during the second year, and one every 12-15 weeks during the third year and thereafter. After the first year of program implementation, each facilitator will be able to take on 12 new practices during the second year, while still being able to sustain contact with the previous 12 practices. Similarly, in the third year, another set of 12 practices will begin the "intense" phase of program implementation.

  Show Detailed Description

  Eligibility

Ages Eligible for Study:   40 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Men and women over 40 years of age, who meet at least one of the following criteria:

    1. have established cardiovascular disease: Coronary Artery Disease, Cerebrovascular disease (documented stroke and/or TIA), and Peripheral Vascular Disease;
    2. have Diabetes Mellitus;
    3. have Chronic Kidney Disease ;
    4. are at high risk for CVD based on a presence of at least three of the following established cardiovascular risk factors: age (males ≥ 45, females ≥ 55), smoker status, hypertension, and dyslipidemia.
  • No restrictions will be imposed on the recruitment process; all practices in the region will be eligible to participate.

Exclusion Criteria:

  • see above
  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: NCT00574808

Contacts
Contact: Clare E Liddy, MD, MSc 613-562-4262 ext 1514 cliddy@scohs.on.ca

Locations
Canada, Ontario
Elisabeth Bruyere Health Centre Recruiting
Ottawa, Ontario, Canada, K1N 5C4
Principal Investigator: Clare E Liddy, MD, MSc         
Principal Investigator: William Hogg, MD         
Sponsors and Collaborators
C. T. Lamont Primary Care Research Centre
Dept of Family Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel
Institute of Population Health, University of Ottawa
University of Ottawa Heart Institute
Ottawa Cardiovascular Centre
Ottawa Regional Stroke Program
Bruyere Research Institute
Champlain Primary Care Practices
Investigators
Principal Investigator: Clare E Liddy, MD, MSc University of Ottawa
Principal Investigator: William Hogg, MD, MSc University of Ottawa
  More Information

Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Clare Liddy, MD, MSc., University of Ottawa
ClinicalTrials.gov Identifier: NCT00574808     History of Changes
Other Study ID Numbers: IDOCC, 937200801
Study First Received: December 14, 2007
Last Updated: December 14, 2007
Health Authority: Canada: Ethics Review Committee
Canada:Champlain Cardiovascular Prevention Network

Keywords provided by C. T. Lamont Primary Care Research Centre:
Primary care
Prevention of Cardiovascular Disease
Chronic Disease Management
Chronic Disease Prevention
Chronic Care Model
Outreach Facilitation

Additional relevant MeSH terms:
Ischemic Attack, Transient
Hypertension
Cardiovascular Diseases
Kidney Diseases
Renal Insufficiency, Chronic
Dyslipidemias
Vascular Diseases
Urologic Diseases
Renal Insufficiency
Lipid Metabolism Disorders
Metabolic Diseases
Brain Ischemia
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases

ClinicalTrials.gov processed this record on September 18, 2014