Patient and Provider Attitudes in the Healthcare Context

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00404027
Recruitment Status : Completed
First Posted : November 27, 2006
Last Update Posted : June 6, 2017
Information provided by (Responsible Party):
VA Office of Research and Development

Brief Summary:
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 or disease
Diabetes Mellitus Hypertension

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.

Study Type : Observational
Actual Enrollment : 300 participants
Observational Model: Cohort
Time Perspective: Retrospective
Official Title: Patient and Provider Attitudes in the Healthcare Context
Actual Study Start Date : June 4, 2007
Actual Primary Completion Date : October 1, 2010
Actual Study Completion Date : October 1, 2010

Primary Outcome Measures :
  1. PPOS scores [ Time Frame: same day as appointment with provider ]
    Patient-Practitioner Orientation Scale: degree of symmetry between patient and provider regarding patient-centeredness

Secondary Outcome Measures :
  1. Blood pressure [ Time Frame: Same day as appointment with provider ]
    Blood pressure measured at time of provider visit

  2. Hemoglobin A1c [ Time Frame: Same day as appointment with provider ]
    Hemoglobin A1c, to assess glycemic control

Information from the National Library of Medicine

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, Learn About Clinical Studies.

Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population
Veteran primary care patients

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.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00404027

United States, Iowa
Iowa City VA Health Care System, Iowa City, IA
Iowa City, Iowa, United States, 52246-2208
Sponsors and Collaborators
VA Office of Research and Development
Principal Investigator: Alan J. Christensen, PhD Iowa City VA Health Care System, Iowa City, IA

Publications of Results:
Baldwin AS, Vander Weg MW, Christensen AJ, Rothman AJ. Examining the Causal Mechanisms Underlying Self-generated Arguments for Health Behavior Change. [Abstract]. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. 2009 Apr 1; 37(S):229.

Responsible Party: VA Office of Research and Development Identifier: NCT00404027     History of Changes
Other Study ID Numbers: IIR 04-201
First Posted: November 27, 2006    Key Record Dates
Last Update Posted: June 6, 2017
Last Verified: June 2017

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