Optimizing Audit and Feedback for Primary Care

NCT00996645 | Completed

• 1 other identifier: 271-2006
• Study Type: interventional
• Target: 55
• Locations: 1 country
• Sites: 1

Brief Summary

There remains a large gap between ideal and actual care provided to patients with chronic diseases. Performance feedback reports are often used as a foundation for quality improvement interventions. There have been hundreds of trials investigating the use of feedback reports; the important question to ask now is not whether performance feedback reports can help to improve quality of care, but how to optimize feedback interventions to accomplish that goal. The purpose of this study is to test whether a theory-based intervention added to feedback reports sent to primary care providers can result in improved outcomes for patients with chronic disease.

Conditions

Diabetes Mellitus, Type 2; Coronary Artery Disease

Keywords

Diabetes Mellitus, Type 2; Coronary Artery Disease; Primary Health Care; Feedback, Psychological; Quality Assurance, Health Care

Outcome Measures

Primary Outcomes (2)

• Primary Process Outcome: A composite score counting the number of appropriate processes achieved for patients within appropriate time-frames, including laboratory testing, blood pressure measurements and active prescriptions

  24 months

• Primary Disease-Related Outcomes: mean BP and mean LDL level.

  24 months

Secondary Outcomes (4)

• Prescriptions: percent of patients on insulin, beta blockers, ace-inhibitors or angiotensin-receptor blockers, aspirin, statins.

  24 months

• Subgroup Analysis: 1) Compare effect of intervention for patients with only diabetes, only coronary artery disease, or both. 2) Compare outcomes for those with high vs low baseline performance.

  24 months

• proportion of patients who are meeting targets recommended in guidelines for glucose, blood pressure and LDL cholesterol

  24 months

• Efficacy of intervention

  24 months

Study Arms (2)

Feedback report only

NO INTERVENTION

This arm will receive performance feedback reports but no worksheet to facilitate goal-setting and action plans.

Goal-Setting Worksheet

EXPERIMENTAL

This arm will receive a theory-informed worksheet to facilitate the development of goals and action plans in response to the performance feedback reports.

Other: Worksheet to facilitate goal-setting and action plans

Interventions

Worksheet to facilitate goal-setting and action plans OTHER

Developed based on goal-setting theory and implementation intentions, the worksheet will be mailed out with the feedback reports and is expected to facilitate improved quality of care in response to feedback reports.

Goal-Setting Worksheet

Eligibility Criteria

• Age: 20 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• family physicians in Ontario who have signed data sharing agreements with the CCORT-ICES EMR team

You may not qualify if:

• specializing in an area (such as palliative care) where general guidelines do not apply

Sponsors & Collaborators

• Sunnybrook Health Sciences Centre: lead
• Institute for Clinical Evaluative Sciences: collaborator
• Canadian Institutes of Health Research (CIHR): collaborator

Study Sites (1)

Sunnybrook Health Sciences Centre

Toronto, Ontario, M4N 3M5, Canada

Location

Related Publications (2)

• Ivers NM, Tu K, Young J, Francis JJ, Barnsley J, Shah BR, Upshur RE, Moineddin R, Grimshaw JM, Zwarenstein M. Feedback GAP: pragmatic, cluster-randomized trial of goal setting and action plans to increase the effectiveness of audit and feedback interventions in primary care. Implement Sci. 2013 Dec 17;8:142. doi: 10.1186/1748-5908-8-142.

  PMID: 24341511 DERIVED

• Ivers NM, Tu K, Francis J, Barnsley J, Shah B, Upshur R, Kiss A, Grimshaw JM, Zwarenstein M. Feedback GAP: study protocol for a cluster-randomized trial of goal setting and action plans to increase the effectiveness of audit and feedback interventions in primary care. Implement Sci. 2010 Dec 17;5:98. doi: 10.1186/1748-5908-5-98.

  PMID: 21167034 DERIVED

MeSH Terms

Conditions

Diabetes Mellitus, Type 2; Coronary Artery Disease

Condition Hierarchy (Ancestors)

Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Coronary Disease; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

Study Officials

• Noah M Ivers, MD

  Sunnybrook Health Sciences Centre

  PRINCIPAL INVESTIGATOR

• Karen Tu, MD MSc

  Sunnybrook Health Sciences Centre

  PRINCIPAL INVESTIGATOR

• Merrick Zwarenstein, MBBS MSc PhD

  Sunnybrook Health Sciences Centre

  PRINCIPAL INVESTIGATOR

• Jack V Tu, MD

  Sunnybrook Health Sciences Centre

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD CCFP PhD(c)

Study Record Dates

• First Submitted: October 15, 2009
• First Posted: October 16, 2009
• Study Start: July 1, 2010
• Primary Completion: August 1, 2012
• Study Completion: August 1, 2012
• Last Updated: June 5, 2013

Record last verified: 2013-06

Locations

CA (1)