Supporting Practices to Adopt Registry-Based Care (SPARC): protocol for a randomized controlled trial.

Area of Science:

• Primary care research
• Health services research
• Diabetes management

Background:

• Diabetes incidence is rising, yet primary care practices struggle with optimal guideline adherence.
• Many practices lack infrastructure for monitoring patient adherence and implementing chronic care changes.
• The Supporting Practices to Adopt Registry-Based Care (SPARC) initiative aims to improve diabetes care through a registry intervention.

Purpose of the Study:

• To evaluate the effectiveness and sustainability of a low-cost intervention for improving diabetes care in primary care settings.
• To assess the impact of a diabetes registry on work process changes and population-based care.
• To understand how to leverage existing practice resources for better chronic condition management.

Main Methods:

• A two-armed randomized controlled trial involving 30 primary care practices.
• Intervention group practices received peer mentors, implementation milestones, and informatics support for registry adoption.
• A mixed-methods approach with data from medical records, observations, and interviews analyzed using grounded theory and the Consolidated Framework for Implementation Research.

Main Results:

• The study will compare changes in patient hemoglobin A1c scores from baseline to year 1 between intervention and control practices.
• Qualitative data will identify contextual factors influencing registry adoption.
• Effectiveness will be assessed by comparing patient-level outcomes.

Conclusions:

• Findings will inform strategies for using practice resources to enhance diabetes care via registries.
• The SPARC study has the potential to validate cost-effective implementation strategies for practice change in primary care.
• Successful registry implementation can improve chronic condition management in primary care settings.