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

On September 28, 2010, Joe Selby made this presentation at the 2010 Annual Conference. Select to access the PowerPoint® presentation (1.2 MB).  

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Slide 1

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

Joe V. Selby, Director
DMCRC Coordinating Center
Kaiser Permanente Northern CA

Image: The Agency for Healthcare Research and Quality logo. This logo appears in the upper left corner of all subsequent slides.

Slide 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.

Slide 3

DMCRC—1
Expanded Executive Committee

• Also includes:
  • Vanderbilt DEcIDE Center—Marie Griffin MD, PI—Comparative Effectiveness of Oral Agents in Type 2 Diabetes.
  • RTI DEcIDE Center—Suzanne West Ph.D. PI—Comparative Effectiveness of Oral Hypoglycemics on Chronic Kidney Disease and on Time to Initiation of Maintenance Insulin.

Slide 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.

Slide 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

Slide 6

Timeline of DMCRC Stakeholders' Meetings

Image: Timeline of DMCRC Stakeholders' Meetings.

First Face-to-Face Meeting June 16, 2009: Initial Topic Nominations and Prioritization Focus on Treatment

First Teleconference Feb. 17, 2010: Focus on DM Prevention

Second Face-to-Face Meeting July 1, 2010: Review Ongoing CER Research Topic Re-prioritization for Both Treatment and Prevention

Slide 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

Slide 8

Secrets of the Sauce: DMCRC 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.

Slide 9

Stakeholder Prioritized List of 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.

Slide 10

Stakeholder Prioritized List of 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.
• Identify effective, affordable ("Chevrolet") programs to support individual behavior change  – 10 votes.

Slide 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.

Slide 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.

Slide 13

Next Steps

Image of the Committee organizational chart.

First tier: Executive Committee—Includes AHRQ, Coordinating, Affiliate Center Leadership

Second Tier: Project Manager

The following committees report to the Project Manager:

• Data Committee
• Methods Committee
• Clinical Committee
• Stakeholder Committee

Slide 14

Next Steps

Same image as Slide 13 except that there is a two-way arrow between the Clinical Committee and the Stakeholder Committee.

Slide 15

Next Steps

Same image Slide 14 except that there is a two-way arrow between the Methods Committee and the Stakeholder Committee; and a two-way arrow between the Data Committee and the Stakeholder Committee.