Using Practice Facilitation in Primary Care Settings to Reduce Risk Factors for Cardiovascular Disease
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 276
- 试验地点
- 2
- 主要终点
- Change in the percentage of patients who had a low density lipoprotein (LDL) test who are prescribed a recommended dose of statin based on risk status if indicated.
研究概览
简要总结
The primary purpose of this study is to evaluate the effectiveness of practice facilitation as a quality improvement strategy for implementing the Million Hearts' ABCS treatment guidelines for reducing cardiovascular disease (CVD) among high-risk patients who receive care in primary care practices in New York City. The ABCS refer to the following: Aspirin in high-risk individuals (A), Blood pressure control and management (B), Cholesterol management (C), and Smoking cessation (S). The long-term goal is to create a robust infrastructure to disseminate and implement evidence based practice guidelines (EBPG) findings in primary care practices and improve practices' capacity to receive and implement other EBPG findings in the future.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Prevention
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 18 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Provider and staff eligibility inclusion criteria.
- •Eligibility includes working full or part time at the study site.
- •Stakeholder eligibility inclusion criteria.
- •Steering committee members or other key stakeholder from the following groups: Health Plan Chief Medical Officer, State health officials in the Chronic Disease Program, and leadership from relevant national associations (American Heart Association), members of Advisory Board of CHCANYS (these are physician leaders).
- •Patient eligibility inclusion criteria:
- •at least one of the ABCS risk factors for CVD (i.e., hypertension, hyperlipidemia, eligible for aspirin and/or is a current smoker)
- •must have received care at the clinic for at least 12 months
- •Patients eligible for aspirin are those with a documented ICD-9 code for ischemic vascular disease in the last 12 months. Similarly, patients with a diagnosis of hypertension and/or hyperlipidemia will have a documented ICD-9 code for the targeted risk factor
- •Smokers will be identified by a documented ICD-9 code, prescription for a cessation medication in the last 12 months or documentation in the chart (e.g. meaningful use measure) during the last 12 months (see outcome measures)
排除标准
- 未提供
研究组 & 干预措施
Cluster 1
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Follow Up Post Intervention 21 Months (Behavioral)
Cluster 1
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Follow Up Post Intervention 24 Months (Behavioral)
Cluster 1
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Million Hearts ABCS 6 Months (Behavioral)
Cluster 1
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 9 Months (Behavioral)
Cluster 1
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 12 Months (Behavioral)
Cluster 1
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 15 Months (Behavioral)
Cluster 1
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 18 Months (Behavioral)
Cluster 2
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Follow Up Post Intervention 27 Months (Behavioral)
Cluster 2
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 21 Months (Behavioral)
Cluster 2
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Follow Up Post Intervention 24 Months (Behavioral)
Cluster 2
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Million Hearts ABCS 6 Months (Behavioral)
Cluster 2
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Million Hearts ABCS 9 Months (Behavioral)
Cluster 2
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 12 Months (Behavioral)
Cluster 2
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 15 Months (Behavioral)
Cluster 2
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 18 Months (Behavioral)
Cluster 3
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 21 Months (Behavioral)
Cluster 3
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 24 Months (Behavioral)
Cluster 3
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Follow Up Post Intervention 27 Months (Behavioral)
Cluster 3
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Follow Up Post Intervention 30 Months (Behavioral)
Cluster 3
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Million Hearts ABCS 6 Months (Behavioral)
Cluster 3
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Million Hearts ABCS 9 Months (Behavioral)
Cluster 3
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Million Hearts ABCS 12 Months (Behavioral)
Cluster 3
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 15 Months (Behavioral)
Cluster 3
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 18 Months (Behavioral)
Cluster 4
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 18 Months (Behavioral)
Cluster 4
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 21 Months (Behavioral)
Cluster 4
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 24 Months (Behavioral)
Cluster 4
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Standard Care Regimen 27 Months (Behavioral)
Cluster 4
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Follow Up Post Intervention 30 Months (Behavioral)
Cluster 4
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Follow Up Post Intervention 33 Months (Behavioral)
Cluster 4
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Million Hearts ABCS 6 Months (Behavioral)
Cluster 4
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Million Hearts ABCS 9 Months (Behavioral)
Cluster 4
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Million Hearts ABCS 12 Months (Behavioral)
Cluster 4
Consists of 80 sites chosen by block randomization in four waves every three months (80 in the first three waves and 60 in the last wave).
干预措施: Million Hearts ABCS 15 Months (Behavioral)
结局指标
主要结局
Change in the percentage of patients who had a low density lipoprotein (LDL) test who are prescribed a recommended dose of statin based on risk status if indicated.
时间窗: 18 Months
Percentage of patients with documented use of aspirin or other antithrombotic.
时间窗: 18 Months
Percentage of patients who had a diagnosis of hypertension (HTN) and whose blood pressure (BP) was adequately controlled
时间窗: 18 Months
Percentage of patients who had a fasting lipoprotein (LDL) test performed and whose risk-stratified fasting LDL is at or below the recommended low density lipoprotein (LDL) goal
时间窗: 18 Months
Percentage of patients who were screened about tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user.
时间窗: 24 Months
次要结局
- Percentage of patients aged 18 through 85 years of age who had a diagnosis of hypertension (HTN) who are prescribed recommended medications, if indicated.(18 Months)