Abstract
BACKGROUND
Disease registries, audit and feedback, and clinical reminders have been reported to improve care processes.
OBJECTIVE
To assess the effects of a registry-generated audit, feedback, and patient reminder intervention on diabetes care.
DESIGN
Randomized controlled trial conducted in a resident continuity clinic during the 2003–2004 academic year.
PARTICIPANTS
Seventy-eight categorical Internal Medicine residents caring for 483 diabetic patients participated. Residents randomized to the intervention (n = 39) received instruction on diabetes registry use; quarterly performance audit, feedback, and written reports identifying patients needing care; and had letters sent quarterly to patients needing hemoglobin A1c or cholesterol testing. Residents randomized to the control group (n = 39) received usual clinic education.
MEASUREMENTS
Hemoglobin A1c and lipid monitoring, and the achievement of intermediate clinical outcomes (hemoglobin A1c <7.0%, LDL cholesterol <100 mg/dL, and blood pressure <130/85 mmHg) were assessed.
RESULTS
Patients cared for by residents in the intervention group had higher adherence to guideline recommendations for hemoglobin A1c testing (61.5% vs 48.1%, p = .01) and LDL testing (75.8% vs 64.1%, p = .02). Intermediate clinical outcomes were not different between groups.
CONCLUSIONS
Use of a registry-generated audit, feedback, and patient reminder intervention in a resident continuity clinic modestly improved diabetes care processes, but did not influence intermediate clinical outcomes.
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Acknowledgements
This study was funded by an Education Innovation Award, provided by the Mayo Clinic College of Medicine. The sponsor had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. The primary author had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
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Thomas, K.G., Thomas, M.R., Stroebel, R.J. et al. Use of a Registry-generated Audit, Feedback, and Patient Reminder Intervention in an Internal Medicine Resident Clinic—A Randomized Trial. J GEN INTERN MED 22, 1740–1744 (2007). https://doi.org/10.1007/s11606-007-0431-x
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DOI: https://doi.org/10.1007/s11606-007-0431-x