A Practical Randomized Trial to Improve Diabetes Care

Overview

Journal J Gen Intern Med

Publisher Springer

Specialty General Medicine

Date 2004 Dec 22

PMID 15610326

Citations 34

Authors

Russell E Glasgow

Paul A Nutting

Diane K King

Candace C Nelson

Gary Cutter

Bridget Gaglio

Alanna Kulchak Rahm

Holly Whitesides

Hilarea Amthauer

Affiliations

Soon will be listed here.

Abstract

Objective: There is a well-documented gap between diabetes care guidelines and the services received by patients in almost all health care settings. This project reports initial results from a computer-assisted, patient-centered intervention to improve the level of recommended services received by patients from a wide variety of primary care providers.

Design And Settings: Eight hundred eighty-six patients with type 2 diabetes under the care of 52 primary care physicians participated in the Diabetes Priority Program. Physicians were stratified and randomized to intervention or control conditions and evaluated on 2 primary outcomes: number of recommended laboratory screenings and recommended patient-centered care activities completed. Secondary outcomes were evaluated using the Problem Areas in Diabetes scale and the Patient Health Questionnaire (PHQ)-9 depression scale, and the RE-AIM framework was used to evaluate potential for dissemination.

Results: The program was well-implemented and significantly improved both number of recommended laboratory assays (3.4 vs 3.1; P <.001) and patient-centered aspects of diabetes care patients received (3.6 vs 3.2; P <.001) compared to those in randomized control practices. Activities that were increased most were foot exams (follow-up rates of 80% vs 52%; P <.003) and nutrition counseling (76% vs 52%; P <.001).

Conclusions: Patients are very willing to participate in a brief computer-assisted intervention that is effective in enhancing quality of diabetes care. Staff in primary care offices can consistently deliver an intervention of this nature, but most physicians were unwilling to participate in this translation research study.

Citing Articles

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Symptom prevalence differences of depression as measured by BDI and PHQ scales in the Look AHEAD study.

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Redesigning Primary Care to Improve Diabetes Outcomes (the UNITED Study).

Peterson K, Carlin C, Solberg L, Jacobsen R, Kriel T, Eder M Diabetes Care. 2019; 43(3):549-555.

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