Theory and evidence for an intervention to improve clinicians’ diabetes care: the IDEA trial

Abstract

Background: Evidence suggests that care delivered to patients with diabetes might be improved by intervention to change the behaviour of physicians and nurses. Prior to trialling a dual process theory- and evidence-based intervention, this study aimed to identify whether clinician behaviours and theoretical predictors show room for improvement. Methods: Questionnaires were sent to clinicians in 44 primary care practices, addressing performance of six separate clinician behaviours involving prescribing, advising and examining for diabetes management, and cognitions about these behaviours Findings: Questionnaires were completed by 219 clinicians (67% response rate). For all six behaviours, clinicians reported performance was less than 100% of patients (range 54.9% for prescribing to 82.3% for foot examination). All except foot examination had mean scores < 5 (7-point scale) for self-efficacy, coping-planning or automaticity. Discussion: There was room for improvement in all behaviours and all cognitions theorised to determine the behaviours (especially self-efficacy, coping-planning and automaticity). Therefore an intervention designed to change these behaviours by targeting the investigated predictors has the potential to be effective and is currently being evaluated.