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Diabetes

Diabetes is the fifth leading cause of death among adults in the US and affects more than 8% of the US adult population with annual total related health costs estimated at $132 billion. The growing incidence of this illness makes improving the quality of diabetes care in primary care practices of pressing importance. The majority of adults with type 2 diabetes seek their care from primary care physicians but the quality of diabetes care typically provided in these settings leaves room for improvement. Addressing this gap will have a large impact on reducing the excess morbidity and mortality faced by these patients and on reducing the growing health system costs of diabetes.

Our research team is conducting research on how to improve diabetes care in primary care practices and on how health system and patient factors interact with these efforts. As a TRIAD study site (insert link) we continue to explore these issues in partnership with other researchers around the country.

Our grants and papers in this area are indicative of our commitment to developing the knowledge base and tools needed to help primary care practices improve diabetes care and to inform health systems on how they can support these efforts.

PUBLICATIONS:

  • Ackermann RT, Thompson TJ, Selby JV, Safford MM, Stevens M, Brown AF, Narayan KM; Translating Research into Action for Diabetes (TRIAD) Study Group [Crosson JC]. Is the number of documented diabetes process-of-care indicators associated with cardiometabolic risk factor levels, patient satisfaction, or self-rated quality of diabetes care? The Translating Research into Action for Diabetes (TRIAD) study. Diabetes Care, 2006;29:2108-13. PMID: 16936161
  • Balasubramanian BA, Chase SM, Nutting PA, Cohen DJ, Ohman-Strickland PA, Crosson JC, Miller WL, Crabtree BF and the ULTRA Study Team. Using Learning Teams for Reflective Adaptation (ULTRA): a quality improvement intervention in primary care practices. Annals of Family Medicine, 2010: (in press).
  • Bilik D, McEwen LN, Brown MB, Selby JV, Karter AJ, Marrero DG, Pomeroy NE, Hsiao VC, Brown AF, Tseng C-W, Mangione CM, Lasser NL, Crosson JC, Herman WH. Thiazolidinediones, cardiovascular disease and cardiovascular mortality: Translating Research Into Action for Diabetes (TRIAD). Pharmacoepidemiology and Drug Safety, 2010: (in press).
  • Crosson JC, Heisler M, Subramanian U, Swain B, Davis GJ, Lasser N, Ross S, Schmittdiel JA, Onyemere K, Tseng C-W. Primary care physicians’ perceptions of barriers to good cardiovascular disease risk factor control among patients with diabetes. Journal of the American Board of Family Medicine, 2010;23:171-8. PMID: 20207927
  • Crosson JC, Ohman-Strickland PA, Campbell S, Phillips RL, Roland MA, Kontopantelis E, Bazemore A, Balasubramanian B, Crabtree BF. A comparison of chronic illness care quality in US and UK family medicine practices prior to pay-for- performance initiatives. Family Practice, 2009;26:510-516. PMID: 19748914
  • Crosson JC, Ohman-Strickland PA, Hahn KA, DiCicco-Bloom B, Shaw E, Orzano AJ, Crabtree BF. Use of electronic medical records and diabetes quality of care: results from a sample of family medicine practices. Annals of Family Medicine, 2007;5:209-215. PMID: 17548848
  • Duru OK, Mangione CM, Steers NW, Herman WH, Karter AJ, Kountz D, Marrero DG, Safford MM, Waitzfelder B Gerzoff RB, Huh S, Brown AF for the TRIAD Study Group [Crosson JC]. The association between clinical care strategies and the attenuation of racial/ethnic disparities in diabetes care: the translating research into action for diabetes (TRIAD) study. Medical Care, 2006;44:1121–1128. PMID: 17122717
  • Ettner SL, Cadwell BL, Russell LB, Brown A, Karter AJ, Safford M, Mangione C, Beckles G, Herman WH, Thompson TJ and the TRIAD Study Group [Crosson JC]. Investing time in health: do socioeconomically disadvantaged patients spend more or less extra time on diabetes self-care? Health Economics, 2009;18:645-663. PMID: 18709636
  • Ettner SL, Thompson TJ, Stevens MR, Mangione CM, Kim C, Steers WN, Goewey J, Brown AF, Chung RS, Narayan KMV and the TRIAD Study Group [Crosson JC]. Are physician reimbursement strategies associated with processes of care and patient satisfaction for patients with diabetes in managed care? HSR: Health Services Research, 2006;41:4, Part I: 1221-41. PMID: 16899004
  • Ferrara A, Williamson DF, Karter AJ, Thompson TJ, Kim C for the Translating Research into Action for Diabetes (TRIAD) Study Group [Crosson JC]. Sex differences in quality of health care received by patients with diabetes in a managed care population. Diabetes Care, 2008;31:69-74. PMID: 17934157
  • Hahn KA, Ferrante JM, Crosson JC, Hudson SV, Crabtree BF. Diabetes flow sheet use associated with guideline adherence. Annals of Family Medicine, 2008;6:235-8. PMID: 18474886
  • Heisler M, Tierney E, Ackerman RT, Tseng C, Venkat Narayan KM, Crosson JC, Waitzfelder B, Safford MM, Duru K, Herman W, Kim C. Physicians’ participatory decision-making and quality of diabetes care processes and outcomes: results from the TRIAD study. Chronic Illness. 2009;5:165-176. PMID: 19675116
  • Karter AJ, Subramanian U, Saha C, Crosson JC, Parker M, Swain B, Marrero D. Barriers to insulin initiation: Translating Research into Action for Diabetes (TRIAD) insulin starts project. Diabetes Care, 2010;33:733-5. PMID: 20086256
  • Kim C, Ferrara A, McEwen LN, Marrero DG, Gerzoff RB, Herman WH, the TRIAD Study Group [Crosson JC]. Preconception care in managed care: The translating research into action for diabetes study. American Journal of Obstetrics and Gynecology, 2005;192, 227-32. PMID: 1567202
  • Mangione CM, Gerzoff RB, Williamson DF, Steers WN, Kerr EA, Brown AF, Waitzfelder BE, Marrero DG, Dudley RA, Kim C, Herman W, Thompson TJ, Safford MM, Selby JV, for the TRIAD Study Group [Crosson JC]. The association between quality of care and the intensity of diabetes disease management programs. Annals of Internal Medicine, 2006;145:107-116. PMID: 16847293
  • McEwen L, Bilik D, Johnson S, Halter J, Karter A, Mangione C, Subramanian U, Waitzfelder B, Crosson J, Herman W. The predictors and impact of intensification of antihyperglycemic therapy in type 2 diabetes: Translating Research Into Action for Diabetes (TRIAD). Diabetes Care, 2009;32:971-6. PMID: 19228862
  • McEwen LN, Kim C, Haan M, Ghosh D, Lantz PM, Mangione CM, Safford MM, Marrero D, Thompson TJ, Herman WH, the TRIAD Study Group [Crosson JC]. Diabetes reporting as a cause of death: results from the translating research into action for diabetes (TRIAD) study. Diabetes Care, 2006;29:247–253. PMID: 16443868
  • Nutting PA, Dickinson WP, Dickinson LM, Nelson CC, King DK, Crabtree BF, Glasgow RE. Use of chronic care model elements is associated with higher-quality care for diabetes. Ann Fam Med 2007; 5(1):14-20.
  • Ohman-Strickland PA, Hudson SV, Piasecki A, Hahn K, Cohen D, Orzano AJ, Parchman ML, Crabtree BF. Features of the Chronic Care Model associated with behavioral counseling and diabetes care in community primary care. Journal of the American Board of Family Medicine 2010; 23(3): 295-305.
  • Ohman-Strickland PA, Orzano AJ, Hudson SV, Solberg LI, DiCiccio-Bloom B, O'Malley D, Tallia AF, Balasubramanian BA, Crabtree BF. Quality of diabetes care in family medicine practices: influence of nurse-practitioners and physician's assistants. Annals of Family Medicine 2008;6:14-22.
  • Orzano AJ, Strickland PO, Tallia AF, Hudson SV, Balasubramanian B, Nutting PA, Crabtree BF. Improving outcomes for high risk diabetics using information systems. Journal of the American Board of Family Medicine 2007;20:245-51.
  • Selby JV, Swain BE, Gerzoff RB, Karter AJ, Waitzfelder BE, Brown AF, Ackermann RT, Duru OK, Ferrara A, Herman W, Marrero DG, Caputo D, Narayan KMV for the TRIAD Study Group [Crosson JC]. Understanding the gap between good processes of diabetes care and poor intermediate outcomes: translating research into action for diabetes (TRIAD). Medical Care, 2007;45:1144-53. PMID: 18007164
  • Tseng C-W, Waitzfelder BE, Tierney E, Gerzoff RB, Marrero DG, Piette JD, Karter AJ, Curb JD, Chung R, Mangione CM, Crosson JC, Dudley RA. Patients’ willingness to discuss trade-offs to lower their out-of-pocket drug costs. Archives of Internal Medicine, 2010: (in press).
  • Tseng C-W, Tierney E, Gerzoff RB, Dudley RA, Waitzfelder B, Ackermann RT, Karter AJ, Piette J, Crosson JC, Ngo-Metzger Q, Chung R, Mangione CM. Race/Ethnicity and economic differences in cost-related medication underuse among insured adults with diabetes. Diabetes Care, 2008;31:261-6. PMID: 18000177
  • The TRIAD study group [Crosson, JC]. Health systems, patients factors and quality of care for diabetes: a synthesis of findings from the TRIAD study. Diabetes Care, 2010;33:940-7. PMID: 2845056

GRANTS:

  • Clemow, PI. “Taking Action by Learning and Knowledge Management to Improve Diabetes Mellitus.” Funded by the National Institute for Diabetes and Digestive and Kidney Diseases. (R34DK083470-01A1) Dates of Activity: 4/15/2010 – 3/31/2012
  • Crosson, PI. “Organizational self-assessment to improve diabetes care in primary care practices.” Funded by the National Institute for Diabetes and Digestive and Kidney Diseases. (R34 DK075417) Dates of Activity: 5/15/08 – 4/30/11
  • Crosson, PI. “Translating Research into Action for Diabetes - Legacy Study.” Submitted to the Centers for Disease Control and Prevention/National Institute for Diabetes and Digestive and Kidney Diseases. Anticipated Dates: 6/2011-5/2014.                        
  • Completed
  • Crosson, PI. “Translating Research into Action for Diabetes II (TRIAD II).” Funded by the Centers for Disease Control and Prevention/National Institute for Diabetes and Digestive and Kidney Diseases. (U58DP223529) Dates of Activity: 2/01/04 – 5/31/10                 
  • Pending