Interprofessional Training to Improve Diabetes Care: The ReSPECT Trial

This study has been completed.
Sponsor:
Collaborators:
Case Western Reserve University
The Cleveland Clinic
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
NCT00854594
First received: February 27, 2009
Last updated: April 14, 2014
Last verified: April 2014
  Purpose

The investigators study focuses on improving the care of diabetes, a complex chronic illness, by providing important insights into interprofessional training and its potential role in fostering the necessary interdisciplinary management needed for chronic conditions and in addressing the gap between best practice and actual care provided.


Condition Intervention
Diabetes Mellitus
Behavioral: Role modeling in Shared medical appointments to Promote Establishing Collaborative Teams (ReSPECT)

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Interprofessional Training for Improving Diabetes Care

Resource links provided by NLM:


Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • A1c from clinical databases [ Time Frame: 22 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Interprofessional Education Perception Scale [ Time Frame: 22 months ] [ Designated as safety issue: No ]
  • Provider Abilities Scale - subscale from the MW Clinicians' Network [ Time Frame: 22 months ] [ Designated as safety issue: No ]
  • Team Climate inventory [ Time Frame: 22 months ] [ Designated as safety issue: No ]
  • Physician Comfort with Delegation [ Time Frame: 22 months ] [ Designated as safety issue: No ]
  • Engagement of non-MD professionals from clinical databases [ Time Frame: 12 months ] [ Designated as safety issue: No ]
  • Number of insulin starts from clinical databases [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Enrollment: 5199
Study Start Date: September 2010
Study Completion Date: September 2013
Primary Completion Date: May 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
No Intervention: Arm 1
Control sites will receive the baseline measures pre and post. These sites will receive traditional diabetes education, which includes teleconsultation.
Experimental: Arm 2
Intervention sites will receive baseline measures pre and post, but also in-depth Shared Medical Appointments (SMA)(The Role modeling in Shared medical appointments to Promote Establishing Collaborative Teams (ReSPECT) intervention) and at 15 months SMA video conferences. At the end of the 18 months the randomly selected patients and providers will be asked to take part in a qualitative interview.
Behavioral: Role modeling in Shared medical appointments to Promote Establishing Collaborative Teams (ReSPECT)
The intervention is designed to educate the clinicians at intervention CBOCs by modeling interprofessional team practices during SMAs for DM patients from each CBOC primary care provider's (PCP) patient panel. We hypothesize that this education at intervention CBOCs will improve interprofessional practices and overall quality care delivered to veterans.
Other Name: ReSPECT

Detailed Description:

The complexity of diabetes management challenges the acute care-oriented healthcare system. Some experts suggest part of the problem is that the healthcare system fosters a separate silos decision making model. While there is increasing recognition that quality diabetes care is best provided in an interdisciplinary manner, interprofessional training models are limited, as is understanding of the links between interprofessional training, actual practice, and patient outcomes. Advancing our understanding of interprofessional training models is critical because most of the complications associated with diabetes (e.g., amputations, renal failure, strokes) can be prevented or delayed with proper management. Our objective is to better understand the processes and mechanisms by which interprofessional training impacts on chronic care management (practice patterns) and the ways it translates into improved patient outcomes.

  Eligibility

Ages Eligible for Study:   25 Years to 85 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

CLINICIANS

  • All clinicians in all of Ohio's CBOCs (except for the Georgetown CBOC) will be eligible for the study (all PCPs have patients with DM in their panel of patients).

PATIENTS

  • All diabetic patients who are seen in Ohio's CBOCs (except for the Georgetown CBOC) will be eligible for the study.

Exclusion Criteria:

CLINICIANS

  • Any clinician who doesn't have diabetic patients on their panel, who aren't apart of Ohio's CBOC's, or see patients at the Georgetown CBOC will not be eligible to participate.

PATIENTS

  • Patients who don't have a diagnosis of diabetes, who aren't seen at one of Ohio's CBOC's, or is seen for their medical care at the Georgetown CBOC will not be eligible to participate.
  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: NCT00854594

Locations
United States, Ohio
VA Medical Center, Cleveland
Cleveland, Ohio, United States, 44106
Sponsors and Collaborators
Case Western Reserve University
The Cleveland Clinic
Investigators
Principal Investigator: Susan R Kirsh, MD VA Medical Center, Cleveland
  More Information

Publications:
Responsible Party: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00854594     History of Changes
Other Study ID Numbers: EDU 08-414
Study First Received: February 27, 2009
Last Updated: April 14, 2014
Health Authority: United States: Federal Government

Keywords provided by Department of Veterans Affairs:
Diabetes
Telemedicine
Shared Medical Appointments

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

ClinicalTrials.gov processed this record on October 23, 2014