Hypertension Clinical Trial
Official title:
Program for Research on the Outcomes of VA Education: Controlled Study of Panel Management and Microsystem Education Interventions to Improve Outcomes in Hypertension and Smoking Cessation
The PROVE aims to test the efficacy of panel management support and educational intervention in VA Primary Care Clinical Microsystems. The study will test three increasingly intensive methods for implementing panel management strategies among health care providers in VA primary care clinics: providing only panel data, providing panel management support, and providing support plus clinical microsystem-enhancing education and training.It is hypothesized that the group receiving panel management and educational interventions will have better smoking cessation and hypertension outcomes than the group receiving only panel management assistance. It is further supposed that the later will have better smoking cessation and hypertension patient outcomes than the data-only group.
Objective:
The specific aims for this study are: (1) to identify health professional educational and
clinical microsystem determinants of outcomes for hypertension and smoking cessation in
veterans. (2) to test the efficacy of three increasingly intensive methods for implementing
panel management strategies among health care providers in VA primary care clinics: providing
only panel data, providing panel management support, and providing support plus clinical
microsystem-enhancing education and training.
Research design:
This project will consist of two phases. Phase I (one year) is the development of the
necessary measurement and data infrastructure to assess health professional education,
microsystem function, and clinical outcomes. In Phase 2 (two years) the study team will
conduct a clinical demonstration project, comparing three interventions in a randomized
controlled trial. Primary care teams will be randomly allocated to one of three arms: 1)
panel management data, 2) panel management data and support, and 3) panel management data,
support and education. The investigators will assess the impact of the implementation of
panel management on primary patient outcomes in hypertension and smoking cessation (blood
pressure and quit rates). The investigative team will also assess the impact of the
implementation of panel management on secondary, intermediary, patient (patient activation,
adherence, behavior change), provider (knowledge and attitudes, self-efficacy, job
satisfaction) and microsystem outcomes (collective efficacy, teamwork, use of data, redesign
of patient processes and provider roles/responsibilities, use of panel management
strategies).
Methodology:
The study will utilize a multi-method, quasi-experimental design at VA NYHHS. Primary care is
delivered through two teams at the Manhattan and five teams at the Brooklyn campuses.
Patients, staff, nurses, and physicians are assigned to specific teams, thereby limiting
contamination in this study.
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