Randomized Control Trials

Battersby MW. Health reform through coordinated care: SA HealthPlus. BMJ 2005; 330(7492):662-5. [Link]
Southern Australia “HealthPlus”:  four regions working on eight sub-trials found that a generic model of coordinated care resulted in improved well-being for people with a wide range of chronic conditions in both rural and urban settings.

Lozano P, Finkelstein JA, Carey VJ et al. A multisite randomized trial of the effects of physician education and organizational change in chronic-asthma care: health outcomes of the Pediatric Asthma Care Patient Outcomes Research Team II Study. Arch Pediatr Adolesc Med 2004; 158.(9):875-83. [Link]
This RCT compared planned asthma care to physician education; planned care was shown to be more effective than physician education alone in decreasing asthma symptom days for children with mild to moderate asthma.

Piatt GA, Orchard TJ, Emerson S et al. Translating the chronic care model into the community: results from a randomized controlled trial of a multifaceted diabetes care intervention. Diabetes Care 2006; 29(4):811-7. [Link]
Implemented in underserved communities, this diabetes RCT found that patients in the CCM group significantly lowered A1C levels, non-HDL cholesterol, & frequency of self monitoring compared to controls. Results of diabetes knowledge and diabetes empowerment also improved, but not significantly more than other groups.

Bauer MS, McBride L, Williford WO et al. Collaborative care for bipolar disorder: Part II. Impact on clinical outcome, function, and costs. Psychiatr Serv 2006; 57(7):937-45. [Link]
Applying CCM concepts (SMS, decision support, planned encounters, and care coordinators) to treatment of bipolar disorder significantly reduced weeks in affective episodes, primarily mania in severely ill, highly comorbid individuals.  In addition, functional outsomes significantly improved. 

Dwight-Johnson M, Ell K, Lee PJ. Can collaborative care address the needs of low-income Latinas with comorbid depression and cancer?  Results from a randomized pilot study. Psychosomatics 2005; 46(3):224-32. [Link]
Among low-income Latinas with comorbid depression and cancer, use of CCM concepts (proactive care, case management, self-management support, and feedback to physicians) resulted in significant improvement in depressive symptoms.  Patients in the intervention group were also more likely to be alive at the end of the study and to have improved emotional well-being. 
Homer CJ, Forbes P, Horvitz L, Peterson LE, Wypij D, Heinrich P. Impact of a quality improvement program on care and outcomes for children with asthma. Arch Pediatr Adolesc Med. 2005 May;159(5):464-9. [Link]

Sites randomized to attend the Breakthrough Series Collaboratives to improve pediatric asthma care showed no differences in patient experience or outcomes. Lack of team motivation to change, as indicated by the fact that less than one-half the randomized teams attended all three learning sessions, may partially explain the results. Serious financial and other organizational factors also may have played a role.

Bibliography Editor

Katie Coleman, M.S.P.H.

Katie Coleman is a research associate with the MacColl Institute and the most recent addition to the ICIC team.  Prior to joining ICIC, she managed a portfolio of government grants for the nation’s largest network of community health centers.  Her research interests include healthcare financing, pay for performance, and access to care including Medicaid and FQHC policy.