Each year, one of the phrases overheard most at the American Diabetes Association (ADA) Scientific Sessions is “improved patient outcomes.” While clinicians and researchers who work with people with type 1 diabetes all agree that improved outcomes are the goal, there is much less agreement on how to measure such improvement. Fairly clear standards exist for reporting outcomes in clinical trials, but there is much less uniformity in reporting outcomes in real-world clinical practice.
This presents a challenge for healthcare innovators – how does one improve diabetes care without a consensus on what the baseline of care is?
The T1D Exchange Quality Improvement Collaborative was formed to address this chicken-or-the-egg data quandary. The Collaborative recruited and supported a collective of diabetes clinics as they worked together to find ways to improve care for people with type 1 diabetes. Each clinic committed to sharing standardized, anonymized data and to make small, measurable changes in care to improve patient outcomes.
In an an abstract accepted at the 79th Scientific Sessions in San Francisco, the T1D Exchange Quality Improvement Collaborative shared early baseline data gathered from the seven diabetes clinics during two time periods – May 2018 and August 2018. Clinicians shared data to measure early interventions aimed at improving care for high-risk patients who had high HbA1c levels the previous year.
Even in this short period of time spanning four months, the research found two notable instances when clinics made changes to improve care:
–Within the past year, Cincinnati Children’s Hospital Medical Center (CCHMC) increased rates of continuous glucose monitor and flash glucose sensor use from an average of 20 percent for people seen in clinic each month between May and July 2018 to 49 percent for people seen in clinic between December 2018 and March 2019. (You can read more about the changes this practice made here.)
-Texas Children’s Hospital improved its efforts to screen for depression. The percentage of eligible patients screened for depression rose at that practice from 35.1 percent in May 2018 to 53.3 percent in August 2018. This is important because studies have shown untreated mental health conditions can lead to problems in blood sugar management.
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Clinicians say they are continuously tracking the data being gathered to find ways to improve the quality of data and to test ways to improve patient outcomes. Dr. Joyce Lee, T1D Exchange Quality Improvement Collaborative faculty, shared that the Collaborative currently is focusing on consistent blood glucose monitoring to support the Collaborative’s global aim to improve glycemic and quality of life outcomes for adolescents and young adults with type 1 diabetes. Dr. Sarah Corathers, another member of the Collaborative faculty, says that this early success motivates their work to improve diabetes care.
“Everyone is inspired by our recent success – increasing the percentage of sensor users across all clinics in the Collaborative. We are motivated to keep moving in this direction and setting more ambitious goals for 2019,” said Dr. Corathers.
To learn more about the Collaborative, click here.
You can read more about T1D Exchange-related research at the ADA 79th Scientific Sessions here.