Ignite Creation Date:
2024-05-05 @ 12:00 PM
Last Modification Date:
2024-10-26 @ 9:18 AM
Study NCT ID:
NCT00201227
Status:
COMPLETED
Last Update Posted:
2017-07-11
First Post:
2005-09-16
Brief Title:
Trial to Enhance Adherence to Multiple Guidelines
Sponsor:
University of Medicine and Dentistry of New Jersey
Organization:
Rutgers The State University of New Jersey
Study Overview
Official Title:
Using Learning Teams for Reflective Adaptation
Status:
COMPLETED
Status Verified Date:
2015-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
ULTRA
Brief Summary:
To evaluate whether the innovative multimethod assessment processparticipatory quality improvement MAPPQI intervention increases adherence to multiple cardiorespiratory guidelines in primary care practice
Detailed Description:
BACKGROUND
Because of its ongoing access to the majority of the US population the primary care setting has great potential for preventing and managing cardiorespiratory illness However due to their broad focus and competing demands primary care practices often fail to translate evidence-based guidelines into practice Based on more than 10 years of practice-based observational and intervention research the investigators have developed a multimethod assessment process MAP for understanding the unique barriers opportunities and complexity of diverse primary care practice settings MAP has been used to inform a practice-individualized intervention that resulted in sustained increases of evidence-based guidelines for clinical preventive service delivery They integrated a participatory quality improvement PQI process that involves patients office staff and physicians with MAP MAPPQI to enhance and promote ongoing practice-specific quality improvement
The study is in response to a Request for Applications on Trials Assessing Innovative Strategies to Improve Clinical Practice Through Guidelines in Heart Lung and Blood Diseases
DESIGN NARRATIVE
This study will evaluate whether the innovative MAPPQI intervention increases adherence to multiple cardiorespiratory guidelines in primary care practice A group randomized clinical trial of 60 primary care practices representing diverse patient populations and payment systems will be conducted After a 2-year follow-up the control group will cross-over to a refined delayed intervention MAP at each practice will identify features that foster andor impede adherence to screening and treatment guidelines for multiple cardiorespiratory diseases among the competing demands of practices PQI will then engage clinicians staff and patients in implementing tailored improvements that target the whole practice and simultaneously focus on changes that affect multiple guidelines Rates of adherence to multiple guidelines will be compared for intervention and control practices A comparative case study process analysis will identify features associated with success The major outcome is adherence to a select group of guidelines addressing hypertension chronic disease asthma cyclic disease diabetes chronic with multiple co-morbidities smoking simple screening and cholesterol complicated The conceptual framework is well developed by the authors with significant prior work in this area These insights will be incorporated into a refined intervention for the control group delayed intervention and evaluated in a prepost design Tailoring MAPPQI to unique practice characteristics is likely to result in sustained increases in adherence to cardiorespiratory guidelines The intervention will be translatable into ongoing implementations of evidence-based guidelines in the primary care setting where the majority of Americans receive their medical care
Because of its ongoing access to the majority of the US population the primary care setting has great potential for preventing and managing cardiorespiratory illness However due to their broad focus and competing demands primary care practices often fail to translate evidence-based guidelines into practice Based on more than 10 years of practice-based observational and intervention research the investigators have developed a multimethod assessment process MAP for understanding the unique barriers opportunities and complexity of diverse primary care practice settings MAP has been used to inform a practice-individualized intervention that resulted in sustained increases of evidence-based guidelines for clinical preventive service delivery They integrated a participatory quality improvement PQI process that involves patients office staff and physicians with MAP MAPPQI to enhance and promote ongoing practice-specific quality improvement
The study is in response to a Request for Applications on Trials Assessing Innovative Strategies to Improve Clinical Practice Through Guidelines in Heart Lung and Blood Diseases
DESIGN NARRATIVE
This study will evaluate whether the innovative MAPPQI intervention increases adherence to multiple cardiorespiratory guidelines in primary care practice A group randomized clinical trial of 60 primary care practices representing diverse patient populations and payment systems will be conducted After a 2-year follow-up the control group will cross-over to a refined delayed intervention MAP at each practice will identify features that foster andor impede adherence to screening and treatment guidelines for multiple cardiorespiratory diseases among the competing demands of practices PQI will then engage clinicians staff and patients in implementing tailored improvements that target the whole practice and simultaneously focus on changes that affect multiple guidelines Rates of adherence to multiple guidelines will be compared for intervention and control practices A comparative case study process analysis will identify features associated with success The major outcome is adherence to a select group of guidelines addressing hypertension chronic disease asthma cyclic disease diabetes chronic with multiple co-morbidities smoking simple screening and cholesterol complicated The conceptual framework is well developed by the authors with significant prior work in this area These insights will be incorporated into a refined intervention for the control group delayed intervention and evaluated in a prepost design Tailoring MAPPQI to unique practice characteristics is likely to result in sustained increases in adherence to cardiorespiratory guidelines The intervention will be translatable into ongoing implementations of evidence-based guidelines in the primary care setting where the majority of Americans receive their medical care
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| R01HL070800 | NIH | None | httpsreporternihgovquickSearchR01HL070800 |