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USE OF MIDLEVEL PROVIDERS IN DIABETES MANAGEMENT

Award Number: R18DK065787
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)
PERIOD OF PERFORMANCE START DATE: 09/01/2004
PERIOD OF PERFORMANCE END DATE: 07/31/2008

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USE OF MIDLEVEL PROVIDERS IN DIABETES MANAGEMENT - DESCRIPTION (provided by applicant): Studies have demonstrated that intensive disease management of diabetes and its associated risk factors, hypertension and dyslipidemia, can prevent the progression of vascular complications. However, implementation of well defined guidelines for intensive disease management has been suboptimal. Barriers to success occur at multiple levels, including health care systems, health care providers and patients. In rural regions of the U.S., reduced availability of primary care providers and specialty services, including diabetes education, present additional barriers to effective diabetes care. Use of a nurse practitioner led interdisciplinary team to intensively manage urban and rural diabetic patients, utilizing telehealth technology to provide care to rural areas, will help begin to address these barriers The long term goal of the project is to develop a practical and sustainable system of intensive diabetes management that will be effective in helping diabetic patients achieve and maintain goals within established treatment guidelines regardless of geographic location. Specific aims are: 1.To determine in both urban and rural areas if a nurse practitioner led team approach to intensive diabetes management and education improves disease-specific outcomes and patient education compared to traditional care (current diabetes management of urban patients). 2. To determine if telehealth is an effective and accepted mechanism for delivery of a nurse practitioner led team approach to intensive diabetes management and education in rural areas. 3. To determine if a nurse practitioner led intensive disease management team can identify patient risk factors (psychological, financial, and work-related factors), that may be barriers to patient adherence, earlier in the management of urban diabetic patients compared to traditional care. 4.To determine health service utilization associated with a nurse practitioner led team approach to diabetes management and education in rural and urban areas compared to that of traditional care. Disease-specific outcomes will include physiologic variables (HbA1c, blood pressure, lipid levels), measurement and documentation of preventive services (dilated eye exam, monofilament exam, microalbumin testing) and patient's knowledge of disease tested by questionnaire. Results should show improved outcomes and patient knowledge in urban and rural patients receiving intensive disease management compared to traditional care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2007 ( Subtotal = $532,466 )
2007	2007	BILLINGS CLINIC FOUNDATION	POST OFFICE BOX 3566	BILLINGS	MT	59103	YELLOWSTONE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	6/18/2007	NON-COMPETING CONTINUATION	$532,466
														Subtotal = $532,466

Issue Date FY: 2006 ( Subtotal = $566,039 )
2006	2006	DEACONESS BILLINGS CLINIC FOUNDATION	2917 10TH AVENUE NORTH	BILLINGS	MT	59101	YELLOWSTONE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	7/13/2006	NON-COMPETING CONTINUATION	$566,039
														Subtotal = $566,039

Issue Date FY: 2005 ( Subtotal = $545,697 )
2005	2005	DEACONESS BILLINGS CLINIC FOUNDATION	2917 10TH AVENUE NORTH	BILLINGS	MT	59101	YELLOWSTONE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	7/25/2005	NON-COMPETING CONTINUATION	$545,697
														Subtotal = $545,697

Issue Date FY: 2004 ( Subtotal = $545,193 )
2004	2004	DEACONESS BILLINGS CLINIC FOUNDATION	2917 10TH AVENUE NORTH	BILLINGS	MT	59101	YELLOWSTONE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	9/22/2004	NEW	$545,193
														Subtotal = $545,193

Grand Total All Awards = $2,189,395

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USE OF MIDLEVEL PROVIDERS IN DIABETES MANAGEMENT

Award Number: R18DK065787

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

PERIOD OF PERFORMANCE START DATE: 09/01/2004

PERIOD OF PERFORMANCE END DATE: 07/31/2008

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