TRANSLATE intervention improved diabetes outcomes

More patients reached target values for systolic BP, LDL and HbA1c at intervention practices.

Primary care settings that implemented TRANSLATE, a multicomponent organizational intervention, experienced patient changes in diabetes process measures, which included improvements in foot and eye exams, renal, LDL and HbA1c tests and BP monitoring.

During 24 months, researchers conducted a group-randomized, controlled clinical trial to evaluate the effectiveness of the intervention. They collected records of 69,965 visits from 8,405 adults with type 2 diabetes. These were taken from 238 health care providers in 24 practices.

Primary care practices that implemented TRANSLATE used an electronic diabetes registry, visit reminders, patient-specific physician alerts and pre-visit planning and monthly performance reviews with a local physician. Primary outcomes were the percent of patients who reached target values for systolic BP (<130 mm Hg), LDL (<100 mg/dL) and HbA1c (<7%) at baseline and one year.

Diabetes process measures increased significantly more at practices that implemented the multicomponent organizational intervention compared with control practices. Further, clinical target values for systolic BP, LDL and HbA1c were reached more in intervention practices compared with control practices.

“Additional studies are needed to examine sustainability, and it is not known whether this methodology will have similar benefits in care of other chronic diseases. This combination of components provides a proven strategy for initiating improvement in clinical diabetes care for many primary care practices,” they wrote. – by Katie Kalvaitis

Diabetes Care. 2008;31:2238-2243.

TRANSLATE intervention

Intervention component	Description
Target high risk	Identify patients at highest risk and begin with them.
Registry	Create a data collection, reporting and support registry.
Admission	Set up admission to oversee changes in roles and responsibilities.
Notify and remind	Notify patients or target deadlines and appointments. Remind patients with patient-specific alerts.
Site coordinator	Select a site coordinator to facilitate in clinic operations.
Local physician champion	Select a lead provider to work with the site coordinator and facilitate in colleague interventions.
Audit and feedback	Audit and review monthly; provide feedback to help improve progress.
Track	Track process measures, outcomes and operational activity.
Education	Education and update staff on diabetes management techniques.