Barriers to Optimum Diabetes Outcomes

获得最佳糖尿病治疗结果的障碍

• 批准号: 7255529
• 负责人: BENJAMIN LITTENBERG
• 金额: $ 15.79万
• 依托单位: UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7255529
• 关键词: Address; Adherence; Adult; Area; Automobile Driving; Award; Blood Pressure; Caring; Cholesterol; Clinical; Clinical Research; Comorbidity; Data; Development; Devices; Diabetes Mellitus; Educational process of instructing; Environment; Healthcare Systems; Hypertension; Information Systems; Investigation; K-Series Research Career Programs; LDL Cholesterol Lipoproteins; Laboratories; Location; Mentors; Outcome; Patient Care; Patients; Pharmaceutical Preparations; Physiological; Prevalence; Primary Health Care; Randomized Clinical Trials; Research; Research Personnel; Role; Surveys; Testing; Time; Translations; Travel; Vermont; Work; career; chronic care model; demographics; diabetic; field survey; functional health literacy; functional status; glycemic control; health care model; illiteracy; improved; medication compliance; satisfaction; skills

DESCRIPTION (provided by applicant): This career development award will allow the candidate to devote 50% of his time to the investigation of barriers to optimum care for patients with diabetes and to the mentoring of research fellows and other junior colleagues. Building on the existing Vermont Diabetes Information System (VDIS, a large scale randomized clinical trial of an information system for primary care of diabetes patients), the candidate proposes four new, complementary projects. These will advance understanding of obstacles to improved physiologic control and provide opportunities for junior colleagues to develop their own skills in clinical research, statistical analysis, and research presentation. Project 1, Practice organization as a barrier to diabetes control: Evaluating the Chronic Care Model, will test the association between conformance with an idealized model of health care and diabetes outcomes including glycemic control, hypertension, cholesterol reduction, and satisfaction with care. The subjects will be sixty primary care practices participating in the VDIS. Project 2, Medication adherence as a barrier to diabetes control: The role of adherence aids, will examine the prevalence and utility of various devices and maneuvers that patients use to remember their medications. The subjects will be 900 adult diabetics from the VDIS Field Survey who provide a comprehensive medication list, a survey of adherence aids, multiple covariates (demographics, comorbidity, complications, functional status, etc.), and physiologic outcomes including A1C, LDL cholesterol, and blood pressure. Project 3, Illiteracy as a barrier to diabetes control: Prevalence and impact of functional health literacy, will document the extent to which functional health literacy is associated with physiologic and clinical outcomes (including A1C, LDL cholesterol, blood pressure, functional status, etc.) in 900 adults with diabetes from the VDIS Field Survey. Project 4, Travel burden as a barrier to diabetes control: The role of driving distance, will assess the role of travel to care upon outcomes (both physiologic and clinical) in 6,000 subjects from the VDIS for whom laboratory results and location data are available. Upon completion, this work will have rigorously addressed four potential barriers to the effective translation of new scientific findings to clinical care while providing junior investigators with mentoring and career development opportunities in diabetes research.

描述（由申请人提供）：