Changes in Physician Performance Through Continuous Professional Development

Asthma Clinical Trial

Official title:

An Evaluation of Changes in Physician Performance Through Continuous Professional Development

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00115284
• Other study ID #: F10011
• Status: Completed
• Phase: N/A
• First received: June 21, 2005
• Last updated: February 12, 2009
• Start date: January 2005
• Est. completion date: December 2006

Study information

• Verified date: February 2009
• Source: Henry Ford Health System
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine whether having physicians evaluate their management of certain diseases as part of board recertification results in improved patient care.

Description:

In the year 2000, the American Board of Internal Medicine introduced continuous professional development as part of its board recertification process. The purpose of these changes were to achieve the following goals:

• To improve the quality of patient care;

• To affirm the high standards expected of a self-regulating, accountable profession;

• To foster continuing scholarship and self-improvement;

• To offer diplomats a portfolio of credentials attesting to competence; and

• To add value to the health care system.

The most notable change in the new recertification process was the addition of practice improvement modules (PIMs). These modules require physicians to review how well they manage a particular chronic disease within their practice and to develop an improvement plan for their practice. In April 2005, it became a requirement that all internists complete a PIM as part of board recertification.

Currently, it not known whether having physicians evaluate their management of certain diseases as part of board recertification will achieve its intended goal of improving patient care. Therefore, the purpose of this trial is to assess whether practice improvement modules result in improved clinical performance.

The PIM selected for this study will focus on asthma. As PIMs seek to improve the quality of care within a practice, the unit of randomization in this study will be clinics (i.e., practices) within the Henry Ford Health System. We will enroll practicing, board-certified internists within the Henry Ford Medical Group (~40 internists or 20 per arm). Clinics (~16 or 8 per arm) will then be randomized to either complete the PIM or not complete the PIM. Participating internists at a site randomized to complete the PIM will be encouraged to work together to complete the asthma PIM. Participating internists at control sites will continue usual care and will not be asked to complete an asthma PIM.

Comparisons: We will assess differences in asthma care by prospectively surveying patients seen by physicians in the intervention group and control group following the intervention period. These analyses will be adjusted by the baseline characteristics of asthma patients seen by participating physicians.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 40
• Est. completion date: December 2006
• Est. primary completion date: July 2006
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Previously board-certified in internal medicine

• Practicing general internist within the Henry Ford Medical Group

Exclusion Criteria:

Study Design

Allocation: Randomized, Intervention Model: Factorial Assignment, Masking: Single Blind

Related Conditions & MeSH terms

• Asthma
• Health Personnel

Intervention

Behavioral:
• ABIM asthma practice improvement module

Locations

Country	Name	City	State
United States	Henry Ford Health System	Detroit	Michigan

Sponsors (1)

Lead Sponsor	Collaborator
Henry Ford Health System

Country where clinical trial is conducted

United States, 

References & Publications (8)

Benson JA Jr. Certification and recertification: one approach to professional accountability. Ann Intern Med. 1991 Feb 1;114(3):238-42. — View Citation

Campbell C, Parboosingh J, Gondocz T, Babitskaya G, Pham B. A study of the factors that influence physicians' commitments to change their practices using learning diaries. Acad Med. 1999 Oct;74(10 Suppl):S34-6. — View Citation

Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA. 1995 Sep 6;274(9):700-5. — View Citation

Glassock RJ, Benson JA Jr, Copeland RB, Godwin HA Jr, Johanson WG Jr, Point W, Popp RL, Scherr L, Stein JH, Taunton OD. Time-limited certification and recertification: the program of the American Board of Internal Medicine. The Task Force on Recertification. Ann Intern Med. 1991 Jan 1;114(1):59-62. — View Citation

Kassirer JP. ABIM looks toward the future. Am J Med. 1996 Feb;100(2):123-4. — View Citation

Norcini JJ, Lipner R, Downing SM. How meaningful are scores on a take-home recertification examination? Acad Med. 1996 Oct;71(10 Suppl):S71-3. — View Citation

Norcini JJ, Lipner RS. Recertification: is there a link between take-home and proctored examinations? Acad Med. 1999 Oct;74(10 Suppl):S28-30. — View Citation

Wasserman SI, Kimball HR, Duffy FD. Recertification in internal medicine: a program of continuous professional development. Task Force on Recertification. Ann Intern Med. 2000 Aug 1;133(3):202-8. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	1) The proportion of patients prescribed inhaled corticosteroids
Secondary	1) The proportion of patients reporting instruction on the proper inhaler technique
Secondary	2) The proportion of patients reporting that asthma triggers were discussed
Secondary	3) The proportion of patients instructed to use short-acting beta-agonists as needed.
Secondary	4) The proportion of patients instructed to use a peak flow meter
Secondary	5) The proportion of patients who received a written action plan for exacerbations
Secondary	6) The proportion of patients reporting nocturnal asthma symptoms in the past month
Secondary	7) The proportion of patients reporting regular use of a rescue inhaler daily.