title: Randomized effectiveness trial of a computer-assisted intervention to improve diabetes care.
abstract: OBJECTIVE
  There is a well-documented gap between diabetes care guidelines and the services received by patients in most health care settings. This report presents 12-month follow-up results from a computer-assisted, patient-centered intervention to improve the level of recommended services patients received from a variety of primary care settings.
  
  
  METHODS
  A total of 886 patients with type 2 diabetes under the care of 52 primary care physicians participated in the Diabetes Priority Program. Physicians were stratified and randomized to intervention or control conditions and evaluated on two primary outcomes: number of recommended laboratory screenings and recommended patient-centered care activities completed from the National Committee on Quality Assurance/American Diabetes Association Provider Recognition Program (PRP). Secondary outcomes were evaluated using the Problem Areas in Diabetes 2 quality of life scale, lipid and HbA1c levels, and the Patient Health Questionnaire-9 depression scale.
  
  
  RESULTS
  The program was well implemented and significantly improved both the number of laboratory assays and patient-centered aspects of diabetes care patients received compared with those in the control condition. There was overall improvement on secondary outcomes of lipids, HbA1c, quality of life, and depression scores; between-condition differences were not significant.
  
  
  CONCLUSIONS
  Staff in small, mixed-payer primary care offices can consistently implement a patient-centered intervention to improve PRP measures of quality of diabetes care. Alternative explanations for why these process improvements did not lead to improved outcomes, and suggested directions for future research are discussed.
authors.affiliation: Kaiser Permanente Colorado, Denver, Colorado, USA. russg@ris.net
authors.forename: Russell E
authors.initials: RE
authors.lastname: Glasgow
authors.forename: Paul A
authors.initials: PA
authors.lastname: Nutting
authors.forename: Diane K
authors.initials: DK
authors.lastname: King
authors.forename: Candace C
authors.initials: CC
authors.lastname: Nelson
authors.forename: Gary
authors.initials: G
authors.lastname: Cutter
authors.forename: Bridget
authors.initials: B
authors.lastname: Gaglio
authors.forename: Alanna Kulchak
authors.initials: AK
authors.lastname: Rahm
authors.forename: Holly
authors.initials: H
authors.lastname: Whitesides
mesh_terms: D003120:Colorado; D003920:Diabetes Mellitus / Q000534:rehabilitation / Q000628:therapy*; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D010808:Physical Examination; D012648:Self Care; D013813:Therapy, Computer-Assisted