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Continuing Medical Education Improves Gastroenterologists’ Compliance with Inflammatory Bowel Disease Quality Measures

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Abstract

Background

Low rates of compliance with quality measures for inflammatory bowel disease (IBD) have been reported for US gastroenterologists.

Aims

We assessed the influence of quality improvement (QI) education on compliance with physician quality reporting system (PQRS) measures for IBD and measures related to National Quality Strategy (NQS) priorities.

Methods

Forty community-based gastroenterologists participated in the QI study; 20 were assigned to educational intervention and control groups, respectively. At baseline, randomly selected charts of patients with moderate-to-severe ulcerative colitis were retrospectively reviewed for the gastroenterologists’ performance of 8 PQRS IBD measures and 4 NQS-related measures. The intervention group participated in a series of accredited continuing medical education (CME) activities focusing on QI. Follow-up chart reviews were conducted 6 months after the CME activities. Independent t tests were conducted to compare between-group differences in baseline-to-follow-up rates of documented compliance with each measure.

Results

The analysis included 299 baseline charts and 300 follow-up charts. The intervention group had significantly greater magnitudes of improvement than the control group for the following measures: assessment of IBD type, location, and activity (+14 %, p = 0.009); influenza vaccination (+13 %, p = 0.025); pneumococcal vaccination (+20 %, p = 0.003); testing for latent tuberculosis before anti-TNF-α therapy (+10 %, p = 0.028); assessment of hepatitis B virus status before anti-TNF-α therapy (+9 %, p = 0.010); assessment of side effects (+17 %, p = 0.048), and counseling patients about cancer risks (+13 %, p = 0.013).

Conclusions

QI-focused CME improves community-based gastroenterologists’ compliance with IBD quality measures and measures aligned with NQS priorities.

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References

  1. American Gastroenterological Association. Adult Inflammatory Bowel Disease Physician Performance Measures Set. https://www.gastro.org/practice/quality-initiatives/IBD_Measures.pdf. Accessed 18.01.2016.

  2. Centers for Medicare & Medicaid Services. Measures Codes. http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/MeasuresCodes.html. Accessed 18.01.2016.

  3. Centers for Medicare & Medicaid Services. Payment Adjustment Information. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Payment-Adjustment-Information.html. Accessed 18.01.2016.

  4. Agency for Healthcare Research and Quality. About the National Quality Strategy (NQS). http://www.ahrq.gov/workingforquality/about.htm. Accessed 18.01.2016.

  5. Feuerstein JD, Lewandowski JJ, Martinez-Vazquez M, et al. Documented compliance with inflammatory bowel disease quality measures is poor. Dig Dis Sci. 2015;60:339–344.

    Article  PubMed  Google Scholar 

  6. Greene L, Sapir T, Moreo K, et al. Impact of quality improvement educational interventions on adherence to quality measures for adults with Crohn’s disease. Inflamm Bowel Dis. 2015;21:2165–2171.

    Article  PubMed  Google Scholar 

  7. Greene L, Moreo K, Sapir T, et al. Use of chart audit and private feedback to improve physician quality and performance measures in ulcerative colitis: preliminary results. J Contin Educ Health Prof. 2014;34:S39–S40.

    Article  Google Scholar 

  8. Greene L, Moreo K. Quality improvement education to improve performance on ulcerative colitis quality measures and care processes aligned with National Quality Strategy priorities. BMJ Qual Improv Report. 2015;4. doi:10.1136/bmjquality.u208829.w3554.

  9. Siegel CA, Allen JI, Melmed GY. Translating improved quality of care into an improved quality of life for patients with inflammatory bowel disease. Clin Gastroenterol Hepatol. 2013;11:908–912.

    Article  PubMed  Google Scholar 

  10. Melmed GY, Siegel CA. Quality improvement in inflammatory bowel disease. Gastroenterol Hepatol (NY). 2013;9:286–292.

    Google Scholar 

  11. Siegel CA. Creating quality measures in IBD. Gastroenterol Hepatol. 2010;6:218–220.

    Google Scholar 

  12. Melmed GY, Siegel CA, Spiegel BM, et al. Quality indicators for inflammatory bowel disease: development of process and outcome measures. Inflamm Bowel Dis. 2013;19:662–668.

    Article  PubMed  Google Scholar 

  13. Satsangi J, Silverberg MS, Vermeire S, et al. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006;55:749–753.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Ivers N, Jamtvedt G, Flottorp S, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012;6:CD000259.

    PubMed  Google Scholar 

  15. Jamtvedt G, Young JM, Kristoffersen DT, et al. Audit and feedback: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2006;2:CD000259.

    PubMed  Google Scholar 

  16. American Gastroenterological Association. Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier. http://www.gastro.org/practice/quality-initiatives/performance-measures/400-1708901-MHC-AGA_PQRS-IBD-Flashcard.pdf. Accessed 18.01.2016.

  17. American Gastroenterological Association. Digestive Health Recognition Program™. http://www.gastro.org/practice-management/quality/quality-reportng/digestive-health-recognition-program-dhrp. Accessed 18.01.2016.

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Acknowledgments

AbbVie, Inc. and Takeda Pharmaceuticals U.S.A., Inc. for providing funding of the study on which the article is based.

Author contribution

Tamar Sapir, Jeffrey D. Carter, Kathleen Moreo, Laurence Greene, Barry Patel, and Peter D.R. Higgins were involved in Study and educational design. Barry Patel, Jeffrey Carter, Tamar Sapir, and Laurence Greene were associated with Chart review and analysis. Tamar Sapir, Kathleen Moreo, Jeffrey D. Carter, and Peter D.R. Higgins did Development and presentation of educational activities. Jeffrey D. Carter, Laurence Greene, Barry Patel, Tamar Sapir, Kathleen Moreo, and Peter D.R. Higgins were involved in Data interpretation and statistical analysis. Laurence Greene, Tamar Sapir, Kathleen Moreo, Jeffrey D. Carter, and Barry Patel contributed to Manuscript drafting. Peter D.R. Higgins, Laurence Greene, Tamar Sapir, Kathleen Moreo, Jeffrey D. Carter, and Barry Patel were involved in Manuscript review and revision.

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Authors and Affiliations

  1. PRIME Education, Inc., 8201 West McNab Road, Tamarac, FL, 33321, USA

    Tamar Sapir, Kathleen Moreo, Jeffrey D. Carter & Laurence Greene

  2. Indegene Total Therapeutic Management, 300 Townpark Dr #100, Kennesaw, GA, 30144, USA

    Barry Patel

  3. Department of Gastroenterology, University of Michigan Health System, 1500 E Medical Center Dr # 391, Ann Arbor, MI, 48109, USA

    Peter D. R. Higgins

Authors
  1. Tamar Sapir
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  2. Kathleen Moreo
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  3. Jeffrey D. Carter
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  4. Laurence Greene
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  5. Barry Patel
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  6. Peter D. R. Higgins
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Corresponding author

Correspondence to Tamar Sapir.

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Conflict of interest

Tamar Sapir, Kathleen Moreo, Jeffrey Carter, and Laurence Greene represent PRIME Education, Inc., a healthcare education company that received independent educational grants from AbbVie, Inc. and Takeda Pharmaceuticals U.S.A., Inc. to conduct the quality improvement project described in this article. The funders had no role in the study design or execution, and the grants did not include support for writing this manuscript. Barry Patel represents Indegene Total Therapeutic Management, a research company contracted by PRIME Education to perform the reviews of patient charts for this study. Peter D.R. Higgins, MD, has received honoraria from PRIME Education, Inc. for participation as faculty in the educational activities described in this article. Dr. Higgins was a prior consultant for AbbVie, Inc.

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Sapir, T., Moreo, K., Carter, J.D. et al. Continuing Medical Education Improves Gastroenterologists’ Compliance with Inflammatory Bowel Disease Quality Measures. Dig Dis Sci 61, 1862–1869 (2016). https://doi.org/10.1007/s10620-016-4061-1

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  • DOI: https://doi.org/10.1007/s10620-016-4061-1

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