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The Role of Stakeholders in the Diabetes Multi-Center Research Consortium (DMCRC)

The Role of Stakeholders in the Diabetes Multi-Center Research Consortium (DMCRC). Joe V Selby MD, Director DMCRC Coordinating Center Kaiser Permanente Northern CA. Diabetes Multi-Center Research Consortium (DMCRC). Coordinating Center HMO Research Network DEcIDE Center

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The Role of Stakeholders in the Diabetes Multi-Center Research Consortium (DMCRC)

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  1. The Role of Stakeholders in the Diabetes Multi-Center Research Consortium (DMCRC) Joe V Selby MD, Director DMCRC Coordinating Center Kaiser Permanente Northern CA

  2. Diabetes Multi-Center Research Consortium (DMCRC) • Coordinating Center • HMO Research Network DEcIDE Center • PI Joe Selby, MD • Co-PI Patrick O’Connor MD • Affiliate Center • Johns Hopkins University DEcIDE Center • PI Jodi Segal, MD • Co-PI Eric Bass, MD • AHRQ Project Officers • Barbara Bartman, MD MPH • Scott Smith, R.Ph., M.S.P.H., Ph.D.

  3. DMCRC – 1 Expanded Executive Committee • Also includes: • VanderbiltDEcIDE Center – Marie Griffin MD, PI – Comparative Effectiveness of Oral Agents in Type 2 Diabetes • RTIDEcIDE Center – Suzanne West Ph.D. PI – Comparative Effectiveness of Oral Hypoglycemics on Chronic Kidney Disease and on Time to Initiation of Maintenance Insulin

  4. Formation and Composition of DMCRC Stakeholders’ Committee • Formation: June 2009 • Composition: • Expanded DMCRC Executive Committee • Government Agencies – AHRQ, NIDDK, CMS, FDA, CDC, VA • Clinicians – ACP,AAFP, AADE • Patients - ADA, individual patient rep.

  5. Purpose of the DMCRC Stakeholders’ Committee • To represent various constituencies and perspectives in a process of nominating and prioritizing topics for AHRQ-funded, empirical CER. • To review AHRQ-funded diabetes-related CER and provide input on: • Interpretation • Dissemination • Future Questions

  6. Timeline of DMCRC Stakeholders’ Meetings First Face-to-Face Meeting June 16, 2009 First Tele- Conference Feb 17, 2010 Second Face-to-face Meeting July 1, 2010 2009 2010 Initial Topic Nominations And Prioritization Focus on Treatment Focus on DM Prevention Review Ongoing CER Research Topic Re-prioritization for Both treatment and Prevention

  7. Format of DMCRC Stakeholders’ Meetings • Greetings and Update from AHRQ ~30 min • Presentation/Discussion of Research ~3 hrs • Findings from CER Work of Consortium members • Review of recent clinical trials findings/implications • Nominations for Topics ~ 2 hrs • All participants invited to offer nominations • Time for Brief Presentations • Voting ~ 30 min • assessing preferences of Stakeholders vs. EC • Brief Review of Results and Next Steps ~ 30 min

  8. Secrets of the SauceDMCRC Stakeholders’ Committee • Meticulous planning with facilitator • Clear goals and game plan • Leave plenty of time for discussion • Facilitator to keep group on track, pull quiet ones out, chair topic nomination segment • Acknowledge relevant work of stakeholders • Demonstrate consequences of prior decisions and prioritization – i.e., funded projects

  9. Stakeholder Prioritized Listof CER Questions on Treatment • Compare 2nd line therapies for their long-term effects (e.g., CVD endpoints) – 19 votes • Compare system approaches to coordinated care vs. usual care – 15 votes • Evaluate strategies to remove barriers to self care (including cost barriers) – 15 votes • Compare various providers and sites for providing behavior change support – 12 votes • Compare strategies for supporting insulin initiation – 9 votes • Compare system-level strategies for supporting adherence to medications – 9 votes

  10. Stakeholder Prioritized Listof CER Questions on Prevention • Compare strengthened linkages between primary care and community resources vs. enhancing primary care to address overweight, lifestyle change – 25 votes • What are effective strategies for counseling patients in the primary care setting for weight loss? (Including issues of coverage) – 21 votes • Compare various approaches to GDM prevention and/or prevention of T2 DM in women with GDM. – 10 votes

  11. Keeping Stakeholders Engaged • Emphasizing the funding by AHRQ of projects that address previously prioritized topics • Presenting and discussing findings from studies they recommended be done • Incorporating their comments and responses into ongoing analyses or taking their suggestions and designing next generation protocols • Identify effective, affordable (“Chevrolet”) programs to support individual behavior change – 10 votes

  12. Challenges • Addressing or managing Stakeholder priority topics not squarely in COE purview • Prevention • Systems-level approaches • Engaging with community • Staying on top and keeping Stakeholders on top of all the research that AHRQ is funding • Adding stakeholders from delivery systems, possibly from industry

  13. Next Steps Executive Committee – Includes AHRQ, Coordinating, Affiliate Center Leadership Project Manger Data Committee Methods Committee Clinical Committee Stakeholder Committee

  14. Next Steps Executive Committee – Includes AHRQ, Coordinating, Affiliate Center Leadership Project Manger Data Committee Methods Committee Clinical Committee Stakeholder Committee

  15. Next Steps Executive Committee – Includes AHRQ, Coordinating, Affiliate Center Leadership Project Manger Data Committee Methods Committee Clinical Committee Stakeholder Committee

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