Automated Diabetes Registry Tools to Enhance Patient Self-Management and Provider Performance Feedback

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Henry Fischer, Denver Health and Hospital Authority
ClinicalTrials.gov Identifier:
NCT00827710
First received: January 14, 2009
Last updated: April 29, 2012
Last verified: April 2012

January 14, 2009
April 29, 2012
December 2007
January 2009   (final data collection date for primary outcome measure)
  • Percent of patients with HgA1c < 7 [ Time Frame: january 2009 ] [ Designated as safety issue: No ]
  • Percent of patients with LDL < 100 mg/dL [ Time Frame: january 2009 ] [ Designated as safety issue: No ]
  • Percent of patients with BP < 130/80 [ Time Frame: january 2009 ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT00827710 on ClinicalTrials.gov Archive Site
  • Percent of patients with A1c checked in last 6 months [ Time Frame: january 2009 ] [ Designated as safety issue: No ]
  • Percent of patients with LDL checked in past year [ Time Frame: january 2009 ] [ Designated as safety issue: No ]
  • Percent of patients with BP checked in past year [ Time Frame: january 2009 ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Automated Diabetes Registry Tools to Enhance Patient Self-Management and Provider Performance Feedback
Not Provided

Can we improve diabetes outcomes through 1) report card mailings to patients 2) point of care distribution of report cards to patients and 3) provider performance feedback with patient level data?

Our federally qualified health care center serves over 7000 diabetic patients, many of whom are uninsured (43%) or on medicaid (18%) or medicare (26%). The population is 54% Latino, 25% Caucasian, and 14% African American. We excluded patients older than 75; those without English or Spanish as a first language; and the homeless. The remaining 5457 patients were randomized to this one-year study which ended January 1, 2009. One-half of the enrolled patients received quarterly mailed report cards on their HgA1c, blood pressure, and lipid performance. They were asked to pick from a list of self-management goals and to see their provider if their last visit was more than 2 months prior to the mailing. In a 2x2 design, our eight clinics were randomized to i) on-site printing of patient report cards or no on-site printing and ii) standard provider performance report cards or enhanced provider report cards. The standard provider report cards included data on provider performance on HgA1c, LDL, and blood pressure compared to other providers. The enhanced provider report card also included a list of up to 10 patients not at HgA1c, LDL, or blood pressure goal. The provider report cards were distributed on a quarterly basis, and the point of care patient report cards were distributed at every clinic visit.

We are analyzing the impact of the intervention on the percent of patients at expert recommended goals for glycemic, lipid, and blood pressure control. We are also performing a qualitative analysis to describe provider and patient attitudes toward the interventions.

Interventional
Not Provided
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Open Label
Primary Purpose: Health Services Research
Diabetes
  • Behavioral: point of care patient report cards
    gives patient feedback on performance on glycemic, lipid, and blood pressure control relative to expert recommended goals
  • Behavioral: Provider performance report card
    Gives provider feedback on performance on their diabetes panel of patients and includes patient level data
  • Active Comparator: 1
    patients who received point-of-care report cards and were listed on provider performance report card
    Interventions:
    • Behavioral: point of care patient report cards
    • Behavioral: Provider performance report card
  • Active Comparator: 2
    Patients who received point-of-care diabetes report cards but were not listed on provider performance report card
    Intervention: Behavioral: point of care patient report cards
  • Active Comparator: 3
    Patients who did not receive point-of-care report card but who were listed on provider performance report card
    Intervention: Behavioral: Provider performance report card
  • No Intervention: 4
    Patients who did not receive point of care report card and who did were not listed on provider performance report card
Fischer HH, Eisert SL, Durfee MJ, Moore SL, Steele AW, McCullen K, Anderson K, Penny L, Mackenzie TD. The impact of tailored diabetes registry report cards on measures of disease control: a nested randomized trial. BMC Med Inform Decis Mak. 2011 Feb 17;11:12. doi: 10.1186/1472-6947-11-12.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
5457
May 2009
January 2009   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • icd9 code for diabetes
  • primary care visit in the past 18 months
  • English or Spanish as primary language

Exclusion Criteria:

  • age more than 75
  • No working address
Both
18 Years to 75 Years
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00827710
AHRQ 290-2006-000-20, AHRQ Contract 290-2006-000-20
Yes
Henry Fischer, Denver Health and Hospital Authority
Denver Health and Hospital Authority
Agency for Healthcare Research and Quality (AHRQ)
Principal Investigator: henry h fischer, md Denver Health and Hospital Authority
Denver Health and Hospital Authority
April 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP