An intervention to overcome clinical inertia and improve diabetes mellitus control in a primary care setting: Improving Primary Care of African Americans with Diabetes (IPCAAD) 8

Archives of Internal Medicine
David C ZiemerLawrence S Phillips

Abstract

Although clinical trials have shown that proper management of diabetes can improve outcomes, and treatment guidelines are widespread, glycated hemoglobin (HbA1c) levels in the United States are rising. Since process measures are improving, poor glycemic control may reflect the failure of health care providers to intensify diabetes therapy when indicated--clinical inertia. We asked whether interventions aimed at health care provider behavior could overcome this barrier and improve glycemic control. In a 3-year trial, 345 internal medicine residents were randomized to be controls or to receive computerized reminders providing patient-specific recommendations at each visit and/or feedback on performance every 2 weeks. When glucose levels exceeded 150 mg/dL (8.33 mmol/L) during visits of 4038 patients, health care provider behavior was characterized as did nothing, did anything (any intensification of therapy), or did enough (if intensification met recommendations). At baseline, residents did anything for 35% of visits and did enough for 21% of visits when changes in therapy were indicated, and there were no differences among intervention groups. During the trial, intensification increased most during the first year and then declin...Continue Reading

Citations

Nov 29, 2007·Journal of General Internal Medicine·Adam J RoseNancy R Kressin
Dec 11, 2007·Journal of General Internal Medicine·Michael E MathenyAlexander Turchin
Oct 19, 2007·Medical Care Research and Review : MCRR·Monica E PeekElbert S Huang
Jun 25, 2009·Journal of General Internal Medicine·Benjamin J PowersEugene Z Oddone
Aug 13, 2011·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Margalit GoldfrachtJacob Dreiher
Dec 1, 2011·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Mohammad A KhanBen S Gerber
Jun 30, 2012·BMC Medicine·Renée M van der LeeuwMaas Jan Heineman
May 15, 2012·Health Services Research·Todd P GilmerHeidi L Ekstrom
Jul 1, 2011·Diabetes Care·Ronald TamlerDerek Leroith
Apr 20, 2010·Substance Use & Misuse·Gail L RoseJohn E Helzer
Sep 14, 2016·Annual Review of Pharmacology and Toxicology·Kim L LavoieTavis S Campbell
May 20, 2017·International Journal of Clinical Practice·Manuel Enrique Machado-DuqueJorge Enrique Machado-Alba
Nov 2, 2006·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Christopher N SciamannaMary Bowen
Dec 19, 2008·Chronic Illness·Andrew Farmer
Feb 11, 2010·Journal of Diabetes Science and Technology·Suzanne Austin BorenFaustine Williams
Sep 23, 2009·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Carlo Bruno GiordaUNKNOWN EFFECTUS Steering Committee
Dec 7, 2007·The Diabetes Educator·Peggy Soule Odegard, Kam Capoccia
Oct 20, 2015·American Journal of Preventive Medicine·Gibril J NjieUNKNOWN Community Preventive Services Task Force
Jun 15, 2012·The Cochrane Database of Systematic Reviews·Noah IversAndrew D Oxman
Oct 21, 2017·Diabetes, Obesity & Metabolism·David Russell-JonesKamlesh Khunti
Mar 9, 2010·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Gina J Ryan
May 27, 2010·Diabetes/metabolism Research and Reviews·Wolfgang GlaesnerTom Bumol
Oct 13, 2010·Academic Medicine : Journal of the Association of American Medical Colleges·Theodore J IwashynaLisa M Bellini
Jul 10, 2009·The Cochrane Database of Systematic Reviews·Kaveh G ShojaniaJeremy Grimshaw
Feb 27, 2013·International Journal of Clinical Practice·E Steinhagen-ThiessenS K Hildemann
Aug 24, 2017·Diabetes, Obesity & Metabolism·Kamlesh KhuntiJesús Medina
Jul 4, 2008·Annals of Saudi Medicine·Fahad A Al-Hussein
Jun 14, 2013·International Journal of Clinical Practice·M C Carratalá-MunueraS Artola-Menéndez
Apr 22, 2016·Diabetes & Metabolism Journal·Eun Ky KimYoung Min Cho
Jan 18, 2014·The Journal of Clinical Hypertension·Dhanashri D KohokRocco Venuto
Feb 6, 2015·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Valerija Bralić LangKsenija Kranjčević

❮ Previous
Next ❯

Related Concepts

Related Feeds

Biomarkers for Type 2 Diabetes

Biomarkers can help understand chronic diseases and assist in risk prediction for prevention and early detection of diseases. Here is the latest research on biomarkers in type 2 diabetes, a disease in which the body is unable to produce or properly use insulin.