Interprofessional Training to Improve Diabetes Care: The ReSPECT Trial - Full Text View

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

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

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
Louis Stokes VA Medical Center
Cleveland, Ohio, United States, 44106-3800

Sponsors and Collaborators

Department of Veterans Affairs

Case Western Reserve University

The Cleveland Clinic

Investigators


Principal Investigator:	Susan R Kirsh, MD	HSR&D Central Office

More Information

Publications:

Kirsh SR, Schaub K, Aron DC. Shared medical appointments: a potential venue for education in interprofessional care. Qual Manag Health Care. 2009 Jul-Sep;18(3):217-24. doi: 10.1097/QMH.0b013e3181aea27d.


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:	December 2, 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 February 27, 2015