TY  - JOUR
T1  - Team-based care approach to cholesterol management in diabetes mellitus: Two-year cluster randomized controlled trial
AU  - Pape GA, Hunt JS, Butler KL, et al
Y1  - 2011/09/12
N1  - 10.1001/archinternmed.2011.417
JO  - Archives of Internal Medicine
SP  - 1480
EP  - 1486
VL  - 171
IS  - 16
N2  - Background 
                  Creative, cost-effective interventions to improve the quality of care of chronic illnesses are needed. This study was designed to evaluate the impact of remote physician-pharmacist team-based care on cholesterol levels in patients with diabetes mellitus (DM).Methods 
                  This 2-year prospective, cluster randomized controlled trial was conducted within the Providence Primary Care Research Network in Oregon. Participants at least 18 years of age were identified by a diagnosis of DM. The intervention included remote physician-pharmacist team-based care focused on cholesterol management in DM. All clinicians in the study had access to the health information technology tool CareManager, which provided automated DM-related point-of-care prompts, a Web-based registry, and performance feedback with benchmarking. Study outcomes included the difference in low-density lipoprotein cholesterol (LDL-C) goal attainment, mean LDL-C, prescribed lipid-lowering therapy, and patient satisfaction between the intervention and control arms.Results 
                  A total of 6963 patients with DM cared for by 68 physicians in 9 clinics were evaluated. Patients in the intervention arm were more likely to achieve their target LDL-C levels compared with controls (78% vs 50%; P = .003). The mean LDL-C level was 12 mg/dL lower in the intervention arm compared with the control arm (P < .001). The rate of LDL-C testing was significantly higher in the intervention arm compared with the control arm. Patients in the intervention arm were also 15% more likely to receive a prescription for a lipid-lowering medication (P = .008). There was no significant difference in patient satisfaction between study arms (P = .15).Conclusion 
                  Remotely located physician-pharmacist team-based care resulted in significantly improved LDL-C levels and goal attainment among patients with DM.
SN  - 0003-9926
M3  - doi: 10.1001/archinternmed.2011.417
UR  - http://dx.doi.org/10.1001/archinternmed.2011.417
ER  -