Improving Child Health by Disseminating Patient Centered Outcomes Research

研究表明，在照顾患有糖尿病的儿童方面，证据和实践之间存在着巨大的差距

Studies document that significant gaps exist between evidence and practice in care for children with chronic illness. The American Board of Pediatrics (ABP) proposes to develop a program in collaboration with Cincinnati Children's Hospital Medical Center (CCHMC) to effectively disseminate patient-centered outcomes research that will improve care and outcomes for children with chronic illness, with an initial focus on optimizing the delivery and outcomes of medication use. The ABP can significantly influence the physician practice behavior of the almost 60,000 diplomates in active clinical practice. Over the last decade, the ABP, as part of a larger effort with the other 24 American Board of Medical Specialties (ABMS) boards, has developed a Maintenance of Certification (MOC) program designed to improve care and outcomes for children. The ABP standards for MOC programs allow credit for measuring performance in practice for physician participation in collaborative improvement networks and self- paced, expert-developed Web-based improvement activities that physicians can complete in their own practice setting. In the past two years, >15,000 pediatricians have completed one of these activities. CCHMC supports collaborative improvement networks that are unique laboratories for studying and improving the effectiveness of therapies in children, including three focused on chronic illness (e.g. cardiology, gastroenterology, and rheumatology). The ABP rewards physician participation in networks with MOC credit. To date, the ABP has notified diplomates of the MOC program requirements and the availability of approved activities but has not actively promoted these activities to its pediatric diplomates. The ABP will develop, implement, and evaluate a program of translational marketing methods with the specific aim of increasing pediatrician use of patient-centered evidence to improve care and outcomes in children with chronic illness, with a specific focus on medication adherence, so that by January 2016: " all pediatric subspecialists in cardiology, gastroenterology, and rheumatology are either 1) participating in one of the relevant collaborative improvement networks that emphasize medication adherence as a key factor in chronic disease management or 2) have completed an ABP-developed web-based medication adherence module for MOC, and " 25% of all subspecialty pediatricians and 75% of cardiology, gastroenterology, and rheumatology subspecialists will have completed ABP-sponsored knowledge self-assessments of current best evidence on medication adherence. These dissemination efforts will provide lessons for how the ABP can best support pediatrician acquisition and implementation of relevant new evidence. This program will also demonstrate to other ABMS boards how physician participation in MOC can lead to dissemination of patient-centered outcomes research. 1