AsthmaNCT00115284
Changes in Physician Performance Through Continuous Professional Development
A study testing ABIM asthma practice improvement module in people with Asthma and Health Personnel, run by Henry Ford Health System at 1 site in United States.
Trial summary
The purpose of this study is to determine whether having physicians evaluate their management of certain diseases as part of board recertification results in improved patient care. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Asthma, Health Personnel
- What is being tested?
- ABIM asthma practice improvement module
- Type of treatment
- Lifestyle or therapy programme
- How many people
- 40 participants
- Where
- 1 siteUnited States
- Study dates
- Jan 2005to Dec 2006
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Previously board-certified in internal medicine
- Practicing general internist within the Henry Ford Medical Group
Who cannot join
- None
Trial locations and contacts
1 site in 1 country.
About this study
Official title: An Evaluation of Changes in Physician Performance Through Continuous Professional Development
The purpose of this study is to determine whether having physicians evaluate their management of certain diseases as part of board recertification results in improved patient care.
Read the detailed description
In the year 2000, the American Board of Internal Medicine introduced continuous professional development as part of its board recertification process. The purpose of these changes were to achieve the following goals:
- To improve the quality of patient care;
- To affirm the high standards expected of a self-regulating, accountable profession;
- To foster continuing scholarship and self-improvement;
- To offer diplomats a portfolio of credentials attesting to competence; and
- To add value to the health care system.
The most notable change in the new recertification process was the addition of practice improvement modules (PIMs). These modules require physicians to review how well they manage a particular chronic disease within their practice and to develop an improvement plan for their practice. In April 2005, it became a requirement that all internists complete a PIM as part of board recertification.
Currently, it not known whether having physicians evaluate their management of certain diseases as part of board recertification will achieve its intended goal of improving patient care. Therefore, the purpose of this trial is to assess whether practice improvement modules result in improved clinical performance.
The PIM selected for this study will focus on asthma. As PIMs seek to improve the quality of care within a practice, the unit of randomization in this study will be clinics (i.e., practices) within the Henry Ford Health System. We will enroll practicing, board-certified internists within the Henry Ford Medical Group (~40 internists or 20 per arm). Clinics (~16 or 8 per arm) will then be randomized to either complete the PIM or not complete the PIM. Participating internists at a site randomized to complete the PIM will be encouraged to work together to complete the asthma PIM. Participating internists at control sites will continue usual care and will not be asked to complete an asthma PIM.
Comparisons: We will assess differences in asthma care by prospectively surveying patients seen by physicians in the intervention group and control group following the intervention period. These analyses will be adjusted by the baseline characteristics of asthma patients seen by participating physicians.
- Conditions
- Asthma, Health Personnel
- Being tested
- ABIM asthma practice improvement module
- Keywords
- Asthma, Education, Medical, Continuing, American Board of Internal Medicine, Recertification, Continuous Professional Development, Practice improvement
- Medical subject headings
- Asthma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ABIM asthma practice improvement moduleBehavioural
What is being measured
The primary outcome is the main question the study is designed to answer.
1) The proportion of patients prescribed inhaled corticosteroids
Secondary outcomes (7)
1) The proportion of patients reporting instruction on the proper inhaler technique
2) The proportion of patients reporting that asthma triggers were discussed
3) The proportion of patients instructed to use short-acting beta-agonists as needed.
4) The proportion of patients instructed to use a peak flow meter
5) The proportion of patients who received a written action plan for exacerbations
6) The proportion of patients reporting nocturnal asthma symptoms in the past month
7) The proportion of patients reporting regular use of a rescue inhaler daily.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Jun 2005 (estimated)
- Study startJan 2005
- Primary completionJul 2006
- Study completionDec 2006
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for AsthmaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- Single blind
- Enrolment
- 40 participants
Sponsor and investigators
- Lead sponsor
- Henry Ford Health System
- Sponsor type
- University, hospital or other
- Investigators
- L. Keoki Williams, MD, MPH, Principal investigator, Center for Health Services Research, Henry Ford Health System
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00115284
- Sponsor's protocol ID
- F10011
- Status last verified
- Feb 2009
- First submitted
- 21 Jun 2005
- Last updated
- 13 Feb 2009
- Results posted
- No
Publications
Benson JA Jr. Certification and recertification: one approach to professional accountability. Ann Intern Med. 1991 Feb 1;114(3):238-42. doi: 10.7326/0003-4819-114-3-238.
PubMed 1984748Glassock RJ, Benson JA Jr, Copeland RB, Godwin HA Jr, Johanson WG Jr, Point W, Popp RL, Scherr L, Stein JH, Taunton OD. Time-limited certification and recertification: the program of the American Board of Internal Medicine. The Task Force on Recertification. Ann Intern Med. 1991 Jan 1;114(1):59-62. doi: 10.7326/0003-4819-114-1-59. No abstract available.
PubMed 1983934Wasserman SI, Kimball HR, Duffy FD. Recertification in internal medicine: a program of continuous professional development. Task Force on Recertification. Ann Intern Med. 2000 Aug 1;133(3):202-8. doi: 10.7326/0003-4819-133-3-200008010-00012.
PubMed 10906835Norcini JJ, Lipner R, Downing SM. How meaningful are scores on a take-home recertification examination? Acad Med. 1996 Oct;71(10 Suppl):S71-3. doi: 10.1097/00001888-199610000-00048. No abstract available.
PubMed 8940939Norcini JJ, Lipner RS. Recertification: is there a link between take-home and proctored examinations? Acad Med. 1999 Oct;74(10 Suppl):S28-30. doi: 10.1097/00001888-199910000-00031. No abstract available.
PubMed 10536585Kassirer JP. ABIM looks toward the future. Am J Med. 1996 Feb;100(2):123-4. doi: 10.1016/s0002-9343(97)89448-x. No abstract available.
PubMed 8629644Campbell C, Parboosingh J, Gondocz T, Babitskaya G, Pham B. A study of the factors that influence physicians' commitments to change their practices using learning diaries. Acad Med. 1999 Oct;74(10 Suppl):S34-6. doi: 10.1097/00001888-199910000-00033. No abstract available.
PubMed 10536587Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA. 1995 Sep 6;274(9):700-5. doi: 10.1001/jama.274.9.700.
PubMed 7650822Simpkins J, Divine G, Wang M, Holmboe E, Pladevall M, Williams LK. Improving asthma care through recertification: a cluster randomized trial. Arch Intern Med. 2007 Nov 12;167(20):2240-8. doi: 10.1001/archinte.167.20.2240.
PubMed 17998498
Study at a glance
From the registry record, last updated by the sponsor on 13 Feb 2009. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- An Evaluation of Changes in Physician Performance Through Continuous Professional Development
- ClinicalTrials.gov ID
- NCT00115284
- Acronym / sponsor ID
- F10011
- Conditions
- Asthma, Health Personnel
- Keywords
- Asthma, Education, Medical, Continuing, American Board of Internal Medicine, Recertification, Continuous Professional Development, Practice improvement
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 40 participants
- Lead sponsor
- Henry Ford Health SystemUniversity, hospital or other
- Study start
- Jan 2005
- Primary completion
- Jul 2006 (actual)
- Study completion
- Dec 2006 (actual)
- First posted
- 22 Jun 2005 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine whether having physicians evaluate their management of certain diseases as part of board recertification results in improved patient care.
Detailed description
In the year 2000, the American Board of Internal Medicine introduced continuous professional development as part of its board recertification process. The purpose of these changes were to achieve the following goals:
- To improve the quality of patient care;
- To affirm the high standards expected of a self-regulating, accountable profession;
- To foster continuing scholarship and self-improvement;
- To offer diplomats a portfolio of credentials attesting to competence; and
- To add value to the health care system.
The most notable change in the new recertification process was the addition of practice improvement modules (PIMs). These modules require physicians to review how well they manage a particular chronic disease within their practice and to develop an improvement plan for their practice. In April 2005, it became a requirement that all internists complete a PIM as part of board recertification.
Currently, it not known whether having physicians evaluate their management of certain diseases as part of board recertification will achieve its intended goal of improving patient care. Therefore, the purpose of this trial is to assess whether practice improvement modules result in improved clinical performance.
The PIM selected for this study will focus on asthma. As PIMs seek to improve the quality of care within a practice, the unit of randomization in this study will be clinics (i.e., practices) within the Henry Ford Health System. We will enroll practicing, board-certified internists within the Henry Ford Medical Group (~40 internists or 20 per arm). Clinics (~16 or 8 per arm) will then be randomized to either complete the PIM or not complete the PIM. Participating internists at a site randomized to complete the PIM will be encouraged to work together to complete the asthma PIM. Participating internists at control sites will continue usual care and will not be asked to complete an asthma PIM.
Comparisons: We will assess differences in asthma care by prospectively surveying patients seen by physicians in the intervention group and control group following the intervention period. These analyses will be adjusted by the baseline characteristics of asthma patients seen by participating physicians.
Study design
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- Single blind
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (2 listed)
- Previously board-certified in internal medicine
- Practicing general internist within the Henry Ford Medical Group
Key exclusion criteria (1 listed)
- None
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ABIM asthma practice improvement module | Behavioural | – |
Primary outcome
1) The proportion of patients prescribed inhaled corticosteroids
7 secondary outcomes
1) The proportion of patients reporting instruction on the proper inhaler technique
2) The proportion of patients reporting that asthma triggers were discussed
3) The proportion of patients instructed to use short-acting beta-agonists as needed.
4) The proportion of patients instructed to use a peak flow meter
5) The proportion of patients who received a written action plan for exacerbations
6) The proportion of patients reporting nocturnal asthma symptoms in the past month
7) The proportion of patients reporting regular use of a rescue inhaler daily.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Feb 2009.
- Background: PubMed 1984748Benson JA Jr. Certification and recertification: one approach to professional accountability. Ann Intern Med. 1991 Feb 1;114(3):238-42. doi: 10.7326/0003-4819-114-3-238.
- Background: PubMed 1983934Glassock RJ, Benson JA Jr, Copeland RB, Godwin HA Jr, Johanson WG Jr, Point W, Popp RL, Scherr L, Stein JH, Taunton OD. Time-limited certification and recertification: the program of the American Board of Internal Medicine. The Task Force on Recertification. Ann Intern Med. 1991 Jan 1;114(1):59-62. doi: 10.7326/0003-4819-114-1-59. No abstract available.
- Background: PubMed 10906835Wasserman SI, Kimball HR, Duffy FD. Recertification in internal medicine: a program of continuous professional development. Task Force on Recertification. Ann Intern Med. 2000 Aug 1;133(3):202-8. doi: 10.7326/0003-4819-133-3-200008010-00012.
- Background: PubMed 8940939Norcini JJ, Lipner R, Downing SM. How meaningful are scores on a take-home recertification examination? Acad Med. 1996 Oct;71(10 Suppl):S71-3. doi: 10.1097/00001888-199610000-00048. No abstract available.
- Background: PubMed 10536585Norcini JJ, Lipner RS. Recertification: is there a link between take-home and proctored examinations? Acad Med. 1999 Oct;74(10 Suppl):S28-30. doi: 10.1097/00001888-199910000-00031. No abstract available.
- Background: PubMed 8629644Kassirer JP. ABIM looks toward the future. Am J Med. 1996 Feb;100(2):123-4. doi: 10.1016/s0002-9343(97)89448-x. No abstract available.
- Background: PubMed 10536587Campbell C, Parboosingh J, Gondocz T, Babitskaya G, Pham B. A study of the factors that influence physicians' commitments to change their practices using learning diaries. Acad Med. 1999 Oct;74(10 Suppl):S34-6. doi: 10.1097/00001888-199910000-00033. No abstract available.
- Background: PubMed 7650822Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA. 1995 Sep 6;274(9):700-5. doi: 10.1001/jama.274.9.700.
- Derived from this study: PubMed 17998498Simpkins J, Divine G, Wang M, Holmboe E, Pladevall M, Williams LK. Improving asthma care through recertification: a cluster randomized trial. Arch Intern Med. 2007 Nov 12;167(20):2240-8. doi: 10.1001/archinte.167.20.2240.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
L. Keoki Williams, MD, MPH principal investigator
Center for Health Services Research, Henry Ford Health System
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing ABIM asthma practice improvement module in people with Asthma and Health Personnel, run by Henry Ford Health System at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 13 Feb 2009. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
1) The proportion of patients prescribed inhaled corticosteroids. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00115284, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Feb 2009.