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Implementation of treat-to-target in rheumatoid arthritis through a Learning Collaborative: Rationale and design of the TRACTION trial
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Authors
Solomon, Daniel H.Lee, Sara B.
Zak, Agnes
Corrigan, Cassandra
Agosti, Jenifer
Bitton, Asaf
Harrold, Leslie R
Losina, Elena
Lu, Bing
Pincus, Ted
Radner, Helga
Smolen, Josef S.
Katz, Jeffrey N.
Fraenkel, Liana
UMass Chan Affiliations
Department of Orthopaedics and Physical RehabilitationDocument Type
Journal ArticlePublication Date
2016-08-01Keywords
Learning collaborativeQuality improvement
Randomized controlled trial
Rheumatoid arthritis
Treat to target
Musculoskeletal Diseases
Rheumatology
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Show full item recordAbstract
BACKGROUND/PURPOSE: Treat-to-target (TTT) is a recommended strategy in the management of rheumatoid arthritis (RA), but various data sources suggest that its uptake in routine care in the US is suboptimal. Herein, we describe the design of a randomized controlled trial of a Learning Collaborative to facilitate implementation of TTT. METHODS: We recruited 11 rheumatology sites from across the US and randomized them into the following two groups: one received the Learning Collaborative intervention in Phase 1 (month 1-9) and the second formed a wait-list control group to receive the intervention in Phase 2 (months 10-18). The Learning Collaborative intervention was designed using the Model for Improvement, consisting of a Change Package with corresponding principles and action phases. Phase 1 intervention practices had nine learning sessions, collaborated using a web-based tool, and shared results of plan-do-study-act cycles and monthly improvement metrics collected at each practice. The wait-list control group sites had no intervention during Phase 1. The primary trial outcome is the implementation of TTT as measured by chart review, comparing the differences from baseline to end of Phase 1, between intervention and control sites. RESULTS: All intervention sites remained engaged in the Learning Collaborative throughout Phase 1, with a total of 38 providers participating. The primary trial outcome measures are currently being collected by the study team through medical record review. CONCLUSIONS: If the Learning Collaborative is an effective means for improving implementation of TTT, this strategy could serve as a way of implementing disseminating TTT more widely.Source
Semin Arthritis Rheum. 2016 Aug;46(1):81-7. doi: 10.1016/j.semarthrit.2016.02.009. Epub 2016 Mar 8. Link to article on publisher's siteDOI
10.1016/j.semarthrit.2016.02.009Permanent Link to this Item
http://hdl.handle.net/20.500.14038/28791PubMed ID
27058970Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.semarthrit.2016.02.009