The long-term goal of the Vermont Diabetes Information System is to reduce morbidity and mortality from diabetes mellitus. The project will implement and evaluate a state-wide system to support evidence-based disease management by primary care providers, their practices and their patients in the community. The primary study question is: """"""""What is the effect of a Diabetes Information System (including education, feedback and decision support) upon disease control measured by glycated hemoglobin?"""""""" Secondary questions address the effect of the system upon adherence to guideline recommendations, blood pressure control, patient satisfaction, medication use, functional status, and health care utilization. We hypothesize that the information system will result in improvements in the process and outcomes of clinical care. There are two specific aims:
Aim 1 : Implement the Diabetes Information System. Objective 1.1: Develop a registry of patients with diabetes in primary care practices in Vermont; Objective 1.2: Provide education and feedback to providers regarding their patients with diabetes; Objective 1.3: Deliver decision support (flow sheets, alerts and reminders), based on the registry and targeted at primary care providers and patients, to prompt ideal management of diabetes.
Aim 2 : Assess the Diabetes Information System. Objective 2.1: Assess disease control and guideline adherence by examining registry data in all subjects in a prospective, two-year, randomized controlled trial in 60 primary care practices; Objective 2.2: Assess outcomes (blood pressure control, obesity, functional status, symptoms, medication use, and satisfaction) by interview and examination in a sub-sample of patients from the controlled trial; Objective 2.3: Assess utilization of health care resources by analyzing administrative data in a sub-sample of patients from the controlled trial.
|Morris, Nancy S; Maclean, Charles D; Littenberg, Benjamin (2013) Change in health literacy over 2 years in older adults with diabetes. Diabetes Educ 39:638-46|
|Morris, Nancy S; Grant, Steven; Repp, Allen et al. (2011) Prevalence of limited health literacy and compensatory strategies used by hospitalized patients. Nurs Res 60:361-6|
|Khan, Shamima; Maclean, Charles D; Littenberg, Benjamin (2010) The effect of the Vermont Diabetes Information System on inpatient and emergency room use: results from a randomized trial. Health Outcomes Res Med 1:e61-e66|
|Maclean, Charles D; Gagnon, Michael; Callas, Peter et al. (2009) The Vermont diabetes information system: a cluster randomized trial of a population based decision support system. J Gen Intern Med 24:1303-10|
|Littenberg, Benjamin; MacLean, Charles D; Zygarowski, Karl et al. (2009) The Vermedx Diabetes Information System reduces healthcare utilization. Am J Manag Care 15:166-70|
|Laramee, Ann S; Morris, Nancy; Littenberg, Benjamin (2007) Relationship of literacy and heart failure in adults with diabetes. BMC Health Serv Res 7:98|
|Ramos-Nino, Maria E; MacLean, Charles D; Littenberg, Benjamin (2007) Association between cancer prevalence and use of thiazolidinediones: results from the Vermont Diabetes Information System. BMC Med 5:17|
|Littenberg, Benjamin; MacLean, Charles D; Hurowitz, Laurie (2006) The use of adherence aids by adults with diabetes: a cross-sectional survey. BMC Fam Pract 7:1|
|Littenberg, Benjamin; MacLean, Charles D (2006) Intra-cluster correlation coefficients in adults with diabetes in primary care practices: the Vermont Diabetes Information System field survey. BMC Med Res Methodol 6:20|
|MacLean, Charles D; Littenberg, Benjamin; Kennedy, Amanda G (2006) Limitations of diabetes pharmacotherapy: results from the Vermont Diabetes Information System study. BMC Fam Pract 7:50|
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