The Role of non-GP Staff in Chronic Disease Management in General Practice.
Trial of Structured Support to Enhance the Role of Non-GP Staff in the Management of Diabetes, Ischaemic Heart Disease and Hypertension in General Practice
Centre for GP Integration Studies, University of New South Wales.
3,000 participants
Jun 1, 2006
Interventional
Conditions
Summary
This is a randomised clinical trial that tests the efficacy of a general practice based intervention to enhance the role of non-GP staff including practice managers, practice nurses and receptionists in chronice diesease management in general practice in terms of its impact on the quality and outcome of care for patients with diabetes and/or ischaemic heart disease and/or hypertension. Key primary measures include an audit of medical records, 20-item patient Assessment of Chronic Illness Care (PACIC), SF-12 (v2), and practice claims of HIC patment for long consultations (Levels C & D), care plans, completed cycles of care, investigations (HbAIc, urinary micro albumin) and eye referral for diabetes and the quality of clinical care measured by clinical care interview. Secondary outcome measures include Team Climate Inventory, the Staff Roles Interview, and a practice profiling survey of practice systems for chronic disease care. These measures will be taken at baseline, 6 and 12 months from baseline.
Eligibility
Plain Language Summary
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Interventions
The Study will recruit general practices within participating Divisions of General Practice. Participating practices will be randomly allocated to intervention group (30 practices) which will receive the intervention immediately following randomisation. Study staff collecting data will be blinded. Method: Six-month intervention driven by the practice with assistance from a facilitator (from the research team). The intervention will focus on establishing practice systems and defining roles and procedures for non-GP staff for the management of patients with type II diabetes or ischaemic heart disease, or hypertension to ensure: evidence based care is offered; patients return for follow-up; adequate access to appointments and length of consultations or group sessions is available; regular and comprehensive assessment and monitoring is carried out; multidisciplinary care needs are identified and plans to address them are implemented; access to structured patient education sessions and patient education resources is available; appropriate referral is made; financial stability of teamwork is optimised through use of Chronic Disease Management (CDM) Medicare items. Each practice in the intervention group will receive the core intervention, consisting of education sessions, practice visits and ongoing support, with additional customisation for each practice's specific circumstances. Located in the practice, the intervention will be conducted through and with the support of the division, who will support practices beyond the intervention period to maintain the effect of the intervention. At the completion of the study, the intervention will be offered to the control practices.
Locations(1)
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ACTRN12605000788673