Study to Evaluate the Effectiveness of a Program Developed to Improve Eye Care for Veterans With Diabetes

Completed · Not applicable

Conditions studied: Diabetes Mellitus, Diabetic Retinopathy

In brief

The study's primary objective is to determine whether the PRSS improves the optimal timing of photocoagulation in diabetic patients in VA. Secondary objectives include assessing if the program: (1) leads to improved compliance with retinopathy screening and surveillance visits; (2) improves patient and provider satisfaction with VA diabetic eye care; (3) reduces eye care visit rates among diabetics receiving eye care at VA; (4) decreases health care resource utilization; and (5) improves the cost-effectiveness of eye care for patients with diabetes

Key facts

Study ID

NCT00119535

Run by

US Department of Veterans Affairs

People needed

2000

Starts

2004-08-01

Expected to finish

2005-12-01

Last updated by the study team

2015-04-07

Who can join

Age: any. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• The population for the project will be all diabetic patients treated at the three VAMCs selected as intervention sites. Therefore, patient recruitment is not required for participation in the initial implementation activities nor in assessing compliance with recommendation for eye examination and treatment. Although the scheduling system will be redesigned and the clinical guidelines will be used to inform eye care clinical decision-making, the final decision about whom should receive diabetes eye care and at what interval will continue to be left to the best clinical judgment of the health care professionals and their patients at each study site. Nothing in this study will preclude a patient and their physician from seeking eye care more frequently or less frequently than recommended by the guidelines. In one regard, this study could be thought of as a study of usual care under two different management and organizational systems without any direct patient-level intervention.
• For data analysis purposes, there will be two sets of inclusion criteria ? EPRP visit criteria and diabetes identification criteria. To be included in the primary data analyses a patient must meet the criteria of the Office of Quality \& Performances quality monitoring program. This criteria includes at least one outpatient visit during the current fiscal year and at least one outpatient visit in the fiscal year prior to the current year (see http://vaww.oqp.med.va.gov/oqp_services/performance_measurement/tech_man.asp). The previous and current qualifying visits must be in any one of 8 clinics (Primary Care (301), General Medicine (323), Cardiology (303), Endocrinology/Metabolism (305), Diabetes (306), Hypertension (309), Pulmonary/Chest (312), or Women's Health (322)) per the West Virginia's Peer Review Organization's External Peer Review Program (EPRP) selection criteria. Eligible patients would be excluded if they had a life expectancy of 6 months or less (e.g., diagnosis of pancreatic cancer or in hospice). For epidemiological comparability, separate cohorts will be constructed for evaluating eye care at the beginning of the study period (for the pre-intervention analyses) and at end of the study period (for the post-intervention analyses). We will identify diabetics (for analytic purposes) by requiring them to meet one of the following criteria in the previous year: 1) one or more prescriptions filled for hypoglycemic medications or self-monitoring blood glucose supplies (as determined by VISTA records), 2) having a diagnosis of diabetes (ICD-9 250.x) recorded in at least 2 separate outpatient encounters, or 3) having a diagnosis of diabetes recorded for one or more inpatient stays.

You may not qualify if…

• None if patient meets inclusion criteria

Where it is running

• VA Greater Los Angeles Healthcare System, West Los Angeles, CA — West Los Angeles, California, United States
• VA Ann Arbor Healthcare System, Ann Arbor, MI — Ann Arbor, Michigan, United States
• Louis Stokes VA Medical Center, Cleveland, OH — Cleveland, Ohio, United States

Full record on ClinicalTrials.gov

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