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Completed

NCT Number: NCT00854594

Interprofessional Training to Improve Diabetes Care: The ReSPECT Trial

The investigators' study focuses on improving the care of diabetes, a complex chronic illness, by providing important insights into interprofessional training and its potential role in fostering the necessary interdisciplinary management needed for chronic conditions and in addressing the gap between best practice and actual care provided.

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Key information

Conditions

Diabetes Mellitus Endocrine System Diseases Glucose Metabolism Disorders Metabolic Diseases Nutritional and Metabolic Diseases

Age range

25 year–85 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Louis Stokes VA Medical Center

Cleveland, Ohio, 44106-3800, United States

About this study

The complexity of diabetes management challenges the acute care-oriented healthcare system. Some experts suggest part of the problem is that the healthcare system fosters a separate silos decision making model. While there is increasing recognition that quality diabetes care is best provided in an interdisciplinary manner, interprofessional training models are limited, as is understanding of the links between interprofessional training, actual practice, and patient outcomes. Advancing our understanding of interprofessional training models is critical because most of the complications associated with diabetes (e.g., amputations, renal failure, strokes) can be prevented or delayed with proper management. The investigators' objective is to better understand the processes and mechanisms by which interprofessional training impacts on chronic care management (practice patterns) and the ways it translates into improved patient outcomes.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

CLINICIANS

  • All clinicians in all of Ohio's CBOCs (except for the Georgetown CBOC) will be eligible for the study (all PCPs have patients with DM in their panel of patients).

PATIENTS

  • All diabetic patients who are seen in Ohio's CBOCs (except for the Georgetown CBOC) will be eligible for the study.

Exclusion criteria

CLINICIANS

  • Any clinician who does not have diabetic patients on their panel, who aren't apart of Ohio's CBOC's, or see patients at the Georgetown CBOC will not be eligible to participate.

PATIENTS

  • Patients who don't have a diagnosis of diabetes, who aren't seen at one of Ohio's CBOC's, or is seen for their medical care at the Georgetown CBOC will not be eligible to participate.

Treatment and study plan

Role modeling in Shared medical appointments to Promote Establishing Collaborative Teams (ReSPECT)

Behavioral

The intervention is designed to educate the clinicians at intervention CBOCs by modeling interprofessional team practices during SMAs for diabetes mellitus (DM) patients from each CBOC primary care provider's (PCP) patient panel. We hypothesize that this education at intervention CBOCs will improve interprofessional practices and overall quality care delivered to veterans.

Other names: ReSPECT

Primary outcomes

  1. Provider Abilities Scale - Subscale From the Midwest (MW) Clinicians' Network

    Time frame: Baseline

    Providers asked to indicate their level of confidence on an 11-point scale, with 0 indicating 'not at all confident' and 10 indicating 'extremely confident' for the following activities:

    • Instruct patients on home glucose monitoring
    • Teach foot care
    • Teach insulin administration
    • Instruct patients about diet
    • Help patients make changes in their diets that you have recommended
    • Instruct patients about regular exercise
    • Help patients make changes in their exercise habits that you have recommended
    • Identify candidates for long-acting insulin
    • Interpret glucose patterns
    • Adjust insulin in insulin-treated patients with poor glycemic control
    • Do you feel comfortable knowing whether to titrate basal insulin versus bolus insulin
    • Manage patients with poor glycemic control
    • Initiate insulin therapy (NPH or insulin glargine and aspart)
    • Apply principles of diabetes care in a team setting

    Averages of provider efficacy were calculated across all activities.

  2. Provider Abilities Scale - Subscale From the Midwest (MW) Clinicians' Network

    Time frame: 22 months (post-intervention)

    Providers asked to indicate their level of confidence on an 11-point scale, with 0 indicating 'not at all confident' and 10 indicating 'extremely confident' for the following activities:

    • Instruct patients on home glucose monitoring
    • Teach foot care
    • Teach insulin administration
    • Instruct patients about diet
    • Help patients make changes in their diets that you have recommended
    • Instruct patients about regular exercise
    • Help patients make changes in their exercise habits that you have recommended
    • Identify candidates for long-acting insulin
    • Interpret glucose patterns
    • Adjust insulin in insulin-treated patients with poor glycemic control
    • Do you feel comfortable knowing whether to titrate basal insulin versus bolus insulin
    • Manage patients with poor glycemic control
    • Initiate insulin therapy (NPH or insulin glargine and aspart)
    • Apply principles of diabetes care in a team setting

    Averages of provider efficacy were calculated across all activities.

Secondary outcomes

  1. Attitudes Toward Healthcare Teams Scale and Subscales

    Time frame: Baseline

    A validated scale developed to assess attitudes towards teams in a healthcare setting with three subscales to assess attitudes toward team value, attitudes toward team efficiency, and attitudes towards physician's shared role on a team. Each of the 21 items is rated 1 to 6, ranging from 'Strongly Disagree' to 'Strongly Agree'. The scale was considered 'complete' for analysis among providers who answered at least 7 of the 21 items. Items were reverse-coded as specified in the subscale development publication. Averages across completed items were calculated within provider. Higher values corresponded with more positive attitudes towards teams.

  2. Attitudes Toward Healthcare Teams Scale and Subscales

    Time frame: 22 months (post-intervention)

    A validated scale developed to assess attitudes towards teams in a healthcare setting with three subscales to assess attitudes toward team value, attitudes toward team efficiency, and attitudes towards physician's shared role on a team. Each of the 21 items is rated 1 to 6, ranging from 'Strongly Disagree' to 'Strongly Agree'. The scale was considered 'complete' for analysis among providers who answered at least 7 of the 21 items. Items were reverse-coded as specified in the subscale development publication. Averages across completed items were calculated within provider. Higher values corresponded with more positive attitudes towards teams.

Sponsors and collaborators

Lead sponsor

US Department of Veterans Affairs

Fed

Collaborators

  • Case Western Reserve University
  • The Cleveland Clinic

Registry information

Official study title

Interprofessional Training for Improving Diabetes Care

Acronym: ReSPECT

Important dates

Study start
2010
Primary completion
2013
Study completion
2013
First posted
Mar 3, 2009
Registry last updated
Oct 6, 2015

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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