The impact of tailored XXXX registry report cards on measures of disease control: a nested randomized trial.

@entity1 @entity6
BACKGROUND: Most studies of @entity6 self-management that show improved clinical outcome performance involve multiple, time-intensive educational sessions in a group format. Most provider performance feedback interventions do not improve intermediate outcomes, yet lack targeted, @entity1 -level feedback. METHODS: 5,457 low-income adults with @entity6 at eight federally-qualified community health centers participated in this nested randomized trial. Half of the @entity1 received report card mailings quarterly; @entity1 at 4 of 8 clinics received report cards at every clinic visit; and providers at 4 of 8 clinics received quarterly performance feedback with targeted @entity1 -level data. Expert-recommended glycemic, lipid, and blood pressure outcomes were assessed. Assessment of report card utility and @entity1 and provider satisfaction was conducted through mailed @entity1 surveys and mid- and post-intervention provider interviews. RESULTS: Many providers and the majority of @entity1 perceived the @entity1 report card as being an effective tool. However, @entity1 report card mailings did not improve process outcomes, nor did point-of-care distribution improve intermediate outcomes. Clinics with @entity1 -level provider performance feedback achieved a greater absolute increase in the percentage of @entity1 at target for glycemic control compared to control clinics (6.4% vs 3.8% respectively, Generalized estimating equations Standard Error 0.014, p < 0.001, CI -0.131 - -0.077). Provider reaction to performance feedback was mixed, with some citing frustration with the lack of both time and ancillary resources. CONCLUSIONS: @entity1 performance report cards were generally well received by @entity1 and providers, but were not associated with improved outcomes. Targeted, @entity1 -level feedback to providers improved glycemic performance. Provider frustration highlights the need to supplement provider outreach efforts. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00827710.
