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A practical randomized trial to improve diabetes care.

Russell E Glasgow¹, Paul A Nutting, Diane K King

¹Kaiser Permanente Colorado, Denver, 81240, USA. russg@ris.net

Journal of General Internal Medicine

|December 22, 2004

Summary

A computer-assisted intervention significantly improved diabetes care quality, increasing recommended screenings and patient-centered activities. Patients readily participated, demonstrating the intervention

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Area of Science:

Primary Care
Diabetes Management
Health Services Research

Background:

A significant gap exists between established diabetes care guidelines and actual patient services received across healthcare settings.
Primary care providers often face challenges in consistently delivering recommended diabetes care.

Purpose of the Study:

To evaluate a computer-assisted, patient-centered intervention designed to enhance the delivery of recommended diabetes care services.
To assess the impact of this intervention on laboratory screenings and patient-centered care activities in primary care.

Main Methods:

A randomized controlled trial involving 886 patients with type 2 diabetes and 52 primary care physicians.
Physicians were randomized to intervention or control groups, with outcomes measured by laboratory screenings and patient-centered care activities.

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Secondary outcomes included patient-reported scales (Problem Areas in Diabetes, PHQ-9) and RE-AIM framework for dissemination potential.

Main Results:

The intervention significantly improved the number of recommended laboratory screenings (3.4 vs 3.1, P <.001) and patient-centered care aspects (3.6 vs 3.2, P <.001).
Key improvements were observed in foot exams (80% vs 52%, P <.003) and nutrition counseling (76% vs 52%, P <.001).

Conclusions:

Patients are highly receptive to brief, computer-assisted interventions for improving diabetes care quality.
Primary care staff can effectively implement such interventions, though physician participation in translation research may be limited.