The Monitor Trial showed that self-monitoring of blood glucose (SMBG) is a low-value test that should not be routine for patients with non-insulin dependent type 2 diabetes. De-adoption of SMBG can minimize the associated costs, both monetary and personal, of SMBG overtreatment. De-adoption may also provide more time and resources for clinicians and patients to focus on treatments with more proven effectiveness for non-insulin dependent type 2 diabetes Successful de-adoption can positively affect end-users by helping primary care clinicians and patients make more patient-centered decisions that reflect their preferences, needs, and values. This study will provide tools and resources to 20 practices and evaluate the effectiveness of the deimplementation of SMBG
This project will explore the impact of COVID-19 on how providers assess glycemic control of patients with type 2 diabetes.
PROMPT: PROmoting diabetes education and Management through Peer Support and Team referral
This NIDDK funded study will investigate methods of increasing referrals to Diabetes Self-Managment and Education Classes with practice level interventions and a team-based approach. Additionally we will randomize people with diabetes who are referred to the Self-management classes to get peer support from someone who has taken the classes or the usual support they get from their provider and care team.
Achieving Blood Pressure Goals after Stroke
A comparative effectiveness study to compare Intensive Tailored Telehealth Management with Intensive Clinical Management to help people who have been recently discharged from the hospital after a stroke achieve healthy blood pressures.
Patient Priorities Care – NC
Implementation and Evaluation of Patient Priorities Care- NC for Older Adults with Multiple Chronic Conditions. This project aims to test a method to engage patients in goal setting and to have care teams incorporate patient goals into care plans.
Improving Provider Announcement Communication Training (IMPACT)
This is a P01 grant which is a grant to support multi-project research programs. The overarching theme of the projects is to improve HPV vaccination communication and uptake by adolescents. Project 1 studies how to involve whole care teams in supporting HPV uptake. Project 2 examines provider motivation. Project 3 will examine who best to facilitate training care teams, and Project 4 will examine how these interventions fit into available resources
Affordability and Efficiency of the COMprehensive Post-Acute Stroke Services (COMPASS)
In this AHRQ funded study we are comparing health care resource utilization between patients that were and were not exposed to a transitional care model of care after an index stroke. As of our last newsletter we published 2 manuscripts on our results to date and look forward to potentially adding a “cost” grant like this one to our newly awarded grant from the Patient Centered Outcomes Research Institute where many of our same COMPASS team members along with many new health systems in several other states will take our initial work to another level and compare 2 different methods of helping patients who recently had a stroke get their blood pressures under control as soon and as safely as possible in order to help prevent recurrent strokes.
Collaborating with the AAFP, Harvard University, and DARTnet, The University of North Carolina is one of 14 sites for the PREPARE Study. This PCORI-funded study will compare asthma outcomes in two groups of patients with persistent asthma. Patients who require daily maintenance medication to control asthma symptoms. The patients will be adults ages 18 to 75 years of self-reported Black or African American descent or Latino heritage. This study will assess if a Patient Activated Rescue Therapy with Inhaled Corticosteroids (PARTICS) reduce exacerbations better than provider education about asthma alone.
The University of Alabama-Birmingham, the University of North Carolina School of Medicine and East Carolina University are collaborating to conduct a study aimed at improving blood pressure in patients residing in the Black Belt region of the United States. The Black Belt is a region in the southeastern part of the USA. The region’s residents, many of which are African American, are at an increased risk for poor health outcomes due to the “Triple Threat” which is: rural residence, minority status and low socioeconomic status. Additionally, the Black Belt is in the center of the Stroke Belt. This project received a $9.4 million grant from the Patient-Centered Outcomes Research Institute (PCORI) to assess the effectiveness of two strategies for improving blood pressure: practice facilitation and the use of peer coaches.
The University of North Carolina at Chapel Hill with the NC Area Health Education Centers Program, Community Care of North Carolina, and NC Healthcare Quality Alliance were awarded a $15M federal grant from the Agency for Healthcare Research and Quality (AHRQ) to help primary care practices use the latest evidence to improve the heart health of millions of Americans. UNC’s Heart Health Now! Advancing Heart Health in NC Primary Care project is one of seven grantees awarded as part of an AHRQ initiative and is aligned with the U.S. Department of Health and Human Services’ (HHS) Million Hearts® national initiative to prevent heart attacks and strokes.
The COMPASS Study is a pragmatic, randomized trial to investigate post-acute stroke care models that are aimed at improving patient functional outcomes and reducing hospital readmissions. Wake Forest University Health Sciences (WFUHS), in partnership with the University of North Carolina and Duke University, joined four other organizations in receiving awards totaling $64 million from the Patient-Centered Outcomes Research Institute (PCORI). The COMPASS study will evaluate a patient-centered, community-based care model to improve secondary prevention, recovery and access to community resources for stroke survivors and caregivers. COMPASS will encourage and facilitate patient and caregiver self-management of care.
Comparing Options for Management: Patient Centered Results for Uterine Fibroids (COMPARE-UF) is a voluntary registry of 10,000 women with uterine fibroids that seeks to answer questions that matter most to patients with fibroids when considering the pros and cons of different treatment options. To help women make these decisions, COMPARE UF will collect information from participants about their medical history, planned and previous treatment for their fibroids, current symptoms, and quality of life.
The Effect of Glucose Monitoring on Patient and Provider Outcomes in Non-Insulin Treated Diabetes (Monitor Trial) project is funded by by the Patient-Centered Outcomes Research Institute (PCORI). For patients living with type 2 diabetes who do not use insulin, decisions regarding self-monitoring of blood glucose (SMBG) is unclear. SMBG testing is a resource-intensive activity without firmly established patient benefits. In this study patients will be randomized into three arms. The first two arms represent common SMBG testing approaches currently being used. The third arm is an enhanced, patient-centered approach to SMBG testing. The practice of medicine is overdue for a pragmatic assessment of the utility of SMBG in everyday, routine clinical practice that evaluates outcomes of central importance to patients living with the disease.
Link to ADAPT-NC dissemination pages
The Asthma Dissemination Around Patient-centered Treatments in North Carolina (ADAPT-NC) project is funded by the Patient-Centered Outcomes Research Institute (PCORI) and brings together the four North Carolina PBRNs in NCNC to study the dissemination of a Shared Decision Making intervention for Asthma Patients. MAPPR at Carolinas Health System successfully demonstrated the efficacy of this intervention in their ACE study. In this study MAPPR, PCRC at Duke, NCnet at UNC and ECARE at ECU are disseminating this intervention across North Carolina to Primary Care and Pediatric Clinics. Clinics have been randomized to different arms of the trial with different “doses” of dissemination to study the efficacy of different dissemination approaches. We would like to thank the Community Care of North Carolina (CCNC) for all their support in making this project possible. Link to Asthma Action Plan
A Program of Education and Training Developed for the Clinical Staff in Community locations, funded by the Duke Endowment. Vidant Health in collaboration with three of the leading North Carolina health care systems are coordinating a Health Coaching Training Program aimed at delivering needed PCMH clinical skills. In addition to Vidant Health, team members include East Carolina University Department of Family Medicine, University of North Carolina at Chapel Hill (UNC-CH) Department of Family Medicine and Carolinas Healthcare System (CHS) in Charlotte. The training was delivered through internet web conferencing.
The Heart-Healthy Lenoir Project is a community-based research project designed to develop and test better ways to reduce heart disease in Lenoir County, from prevention to treatment. The end goal is to create long-term approaches to help Lenoir County reduce heart disease risk and related health problems in the community. The Heart-Healthy Lenoir Project is a collaborative project between several Lenoir County agencies and community members, UNC at Chapel Hill, and ECU Departments of Family Medicine and Public Health. http://www.hearthealthylenoir.com/