Diabetes laboratory monitoring among Veterans with diabetes overdue for lab monitoring and/or retinal screening Nutritional, Metabolic, Endocrine
Conditions
Interventions
This 2-stage SMART trial is a prospective, adaptive, individually randomized trial consisting of two randomization rounds. Randomization is computer-generated using the R package blockrand.
Stage 1:
Sponsors
VA Puget Sound Health Care System
Eligibility
Sex/Gender
All
Age
18 Years to 85 Years
Inclusion criteria
Inclusion criteria: 1. Veterans appearing in the denominator of at least one component electronic quality measure (eQM) (dmg23h_ec subgroup, dmg31h_ec, or ked01_ec) who are not yet meeting the numerator criterion for that component at the time of monthly eligibility assessment (i.e., they are actively due for the associated monitoring activity) 2. Valid contact information 3. Assigned to participating VA site (663) 4. Ages 18-85 (note: dmg23h_ec and dmg31h_ec eligibility is restricted to ages 18-75 per eQM specification; ked01_ec eligibility extends to age 85; patients ages 76-85 may be enrolled via ked01_ec eligibility alone) 5. Have assigned primary care provider in PCMM 6. Have had at least one inpatient or outpatient encounter anywhere in VHA within the three years prior to the eQM reporting period end date
Exclusion criteria
Exclusion criteria: 1. Assigned to H-PACT, GERI, SCI, or HBPC 2. Receiving hospice services in prior year (not included in eQM denominator) 3. 65 years with frailty and advanced illness (dementia medication, advanced illness definition set, or 2 instances of frailty; not included in eQM denominator) 4. Invalid/bad mailing address and invalid/non-working phone number (no valid outreach contact)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Any eligible numerator met (patient-level binary) measured using data collected on the component(s) of the electronic quality measure (eQM) for which the Veterans were eligible at enrollment (DM: HbA1c Missing, DM: Retinal Exam, Timely by Disease, and/or Kidney Health Evaluation for Patients with Diabetes) at the conclusion of the trial observation window | — |
Secondary
| Measure | Time frame |
|---|---|
| EQM component dmg31h_ec completion measured using data collected on the proportion of patients eligible for dmg31h_ec at enrollment who met the retinal exam numerator at trial conclusion;EQM component ked01_ec completion measured using data collected on the proportion of patients eligible for ked01_ec at enrollment who met the kidney health evaluation numerator (eGFR + uACR) at trial conclusion;EQM component dmg23h_ec subgroup completion measured using data collected on the proportion of patients eligible for dmg23h_ec subgroup at enrollment who met the HbA1c monitoring numerator at trial conclusion | — |
Countries
United States of America
Contacts
Public ContactLinnaea;Alaina Schuttner;Mori
;
Outcome results
None listed