Comparative effectiveness research in DARTNet primary care practices: point of care data collection on hypoglycemia and over-the-counter and herbal use among patients diagnosed with diabetes.

Abstract

BACKGROUND:

The Distributed Ambulatory Research in Therapeutics Network (DARTNet) is a federated network of electronic health record (EHR) data, designed as a platform for next-generation comparative effectiveness research in real-world settings. DARTNet links information from nonintegrated primary care clinics that use EHRs to deliver ambulatory care to overcome limitations with traditional observational research.

OBJECTIVE:

Test the ability to conduct a remote, electronic point of care study in DARTNet practices by prompting clinic staff to obtain specific information during a patient encounter.

RESEARCH DESIGN:

Prospective survey of patients identified through queries of clinical data repositories in federated network organizations. On patient visit, survey is triggered and data are relinked to the EHR, de-identified, and copied for evaluation.

SUBJECTS:

Adult patients diagnosed with diabetes mellitus that scheduled a clinic visit for any reason in a 2-week period in DARTNet primary care practices.

MEASURES:

Survey on hypoglycemic events (past month) and over-the-counter and herbal supplement use.

RESULTS:

DARTNet facilitated point of care data collection triggered by an electronic prompt for additional information at a patient visit. More than one-third of respondents (33% response rate) reported either mild (45%) or severe hypoglycemic events (5%) in the month before the survey; only 3 of those were also coded using the ICD-9 (a significant difference in detection rates 37% vs. 1%). Nearly one-quarter of patients reported taking an OTC/herbal, 4% specifically for the treatment of symptoms of diabetes.

CONCLUSIONS:

Prospective data collection is feasible in DARTNet and can enable comparative effectiveness and safety research.

• Authors: Anne M Libby, Wilson Pace, Cathy Bryan, Heather Orton Anderson, Samuel L Ellis, Richard Read Allen, Elias Brandt, Amy G Huebschmann, David West, Robert J Valuck
• Journal: Medical care (Med Care) Vol. 48 Issue 6 Suppl Pg. S39-44 (Jun 2010) ISSN: 1537-1948 [Electronic] United States
• PMID: 20473193 (Publication Type: Journal Article)

Chemical References

• Hypoglycemic Agents
• Nonprescription Drugs
• Plant Preparations

Topics

• Adolescent
• Adult
• Child
• Child, Preschool
• Comparative Effectiveness Research (methods)
• Computer Communication Networks
• Data Collection (methods)
• Diabetes Mellitus (drug therapy)
• Female
• Humans
• Hypoglycemia (chemically induced)
• Hypoglycemic Agents (adverse effects)
• Infant
• Male
• Middle Aged
• Nonprescription Drugs (therapeutic use)
• Pilot Projects
• Plant Preparations (therapeutic use)
• Point-of-Care Systems
• Primary Health Care
• Prospective Studies