Supporting Practices to Adopt Registry-Based Care (SPARC): protocol for a randomized controlled trial.
Supporting Practices to Adopt Registry-Based Care (SPARC): protocol for a randomized controlled trial.
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DOI：
10.1186/s13012-015-0232-2
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发表时间：
2015-04-09
期刊：
影响因子：
--
通讯作者：
Crosson JC
中科院分区：
文献类型：
--
作者：
Etz RS;Keith RE;Maternick AM;Stein KL;Sabo RT;Hayes MS;Sevak P;Holland J;Crosson JC
预计从1995年到2025年，糖尿病的发病率将增加42%。虽然大多数成人糖尿病患者从初级保健机构寻求治疗，但在这些机构中遵守治疗指南并不是最佳的。许多实践缺乏基础设施来监测患者对推荐治疗的依从性，并且在实施对有效管理慢性病患者至关重要的变革方面进展缓慢。支持采用基于登记的护理的实践（SPARC）将评估一项低成本干预措施的有效性和可持续性，该干预措施旨在支持初级保健实践的工作流程变革，并通过实施糖尿病登记加强对基于人群的护理的关注。SPARC是一项双臂随机对照试验（RCT），涉及弗吉尼亚门诊护理结果研究网络（ACORN）的30个初级保健实践。在实践级执行倡导者会议上，将向参与实践的做法（包括对照组）介绍人口健康概念和工具，以便重新设计工作程序和采用登记册。随机分配到干预组的实践将被分配到研究同伴导师，收到一份具体里程碑列表，并有机会接触到医生信息学家。同伴导师是在实践中成功实施登记的临床医生，并将在整个实施过程中帮助支持干预实践。在第一年，同伴导师将每月联系干预实践并每季度访问他们。控制组实践将不会得到注册中心实现的支持或指导。我们将使用混合方法解释顺序设计来指导在基线、12个月和24个月的对照和干预实践中收集病历、参与者观察和半结构化访谈数据。我们将使用有根据的理论和模板指导的方法，使用实施研究综合框架来分析与注册表采用相关的背景因素的定性数据。我们将通过比较患者水平的血红蛋白A1c评分从基线到第一年的变化来评估干预的有效性。研究结果将增强我们对如何利用现有实践资源通过实施和使用登记来改善初级保健实践中的糖尿病护理的理解。SPARC有潜力验证针对初级保健实践变化的低成本实施策略的有效性。NCT02318108本文在线版本（doi:10.1186/s13012-015-0232-2）含有补充资料，请授权用户使用。
Diabetes is predicted to increase in incidence by 42% from 1995 to 2025. Although most adults with diabetes seek care from primary care practices, adherence to treatment guidelines in these settings is not optimal. Many practices lack the infrastructure to monitor patient adherence to recommended treatment and are slow to implement changes critical for effective management of patients with chronic conditions. Supporting Practices to Adopt Registry-Based Care (SPARC) will evaluate effectiveness and sustainability of a low-cost intervention designed to support work process change in primary care practices and enhance focus on population-based care through implementation of a diabetes registry. SPARC is a two-armed randomized controlled trial (RCT) of 30 primary care practices in the Virginia Ambulatory Care Outcomes Research Network (ACORN). Participating practices (including control groups) will be introduced to population health concepts and tools for work process redesign and registry adoption at a meeting of practice-level implementation champions. Practices randomized to the intervention will be assigned study peer mentors, receive a list of specific milestones, and have access to a physician informaticist. Peer mentors are clinicians who successfully implemented registries in their practices and will help champions in the intervention practices throughout the implementation process. During the first year, peer mentors will contact intervention practices monthly and visit them quarterly. Control group practices will not receive support or guidance for registry implementation. We will use a mixed-methods explanatory sequential design to guide collection of medical record, participant observation, and semistructured interview data in control and intervention practices at baseline, 12 months, and 24 months. We will use grounded theory and a template-guided approach using the Consolidated Framework for Implementation Research to analyze qualitative data on contextual factors related to registry adoption. We will assess intervention effectiveness by comparing changes in patient-level hemoglobin A1c scores from baseline to year 1 between intervention and control practices. Findings will enhance our understanding of how to leverage existing practice resources to improve diabetes care in primary care practices by implementing and using a registry. SPARC has the potential to validate the effectiveness of low-cost implementation strategies that target practice change in primary care. NCT02318108 The online version of this article (doi:10.1186/s13012-015-0232-2) contains supplementary material, which is available to authorized users.
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影响因子：
--
作者：
Gupta SK
通讯作者：
Gupta SK
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
5.7
作者：
Davis, Karen;Abrams, Melinda;Stremikis, Kristof
通讯作者：
Stremikis, Kristof
影响因子：
39.2
作者：
Mangione, Carol M.;Gerzoff, Robert B.;Selby, Joe V.
通讯作者：
Selby, Joe V.
影响因子：
16.2
作者：
Grant, Richard;Adams, Alyce S.;Ross-Degnan, Dennis
通讯作者：
Ross-Degnan, Dennis