Diabetes Clinical Trial
Official title:
Addressing Diffusion of Responsibility and Prescribing Burden to Improve Use of Diabetes Medications
Verified date | April 2024 |
Source | Brigham and Women's Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study will test the impact of addressing diffusion of responsibility with and without additional reduction of prescribing burden on SGLT-2i and GLP-1RAs prescribing compared to usual care. Population: MGH primary care physicians caring for at least 2 eligible patients. Eligible patients are individuals age18 years or older with type 2 diabetes and HbA1c >7.5% and a compelling indication for an SGLT-2i or GLP-1RA (including cardiovascular disease, kidney disease, heart failure, or obesity), who are not already prescribed one of these therapies. Intervention: PCPs will be randomized to one of three arms: 1) intervention to address diffusion of responsibility, 2) Intervention to address diffusion of responsibility with additional simplification of prescribing, 3) usual care.
Status | Active, not recruiting |
Enrollment | 191 |
Est. completion date | May 31, 2024 |
Est. primary completion date | November 22, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: Patients: We will use EHR data to identify patients - 18-84 years of age - Diagnosed with type 2 diabetes - Has poorly controlled diabetes (defined as HbA1c >7.5% for ages 18-69 and >8.5% for ages 70-84) - Have a compelling indication for an SGLT-2i or GLP-1RA who are not already prescribed one of these therapies. A compelling indication includes individuals with cardiovascular disease, kidney disease, heart failure, or obesity. Physicians: Physicians will be included if they are - Practicing in primary care at Massachusetts General Hospital - Caring for at least 1 patient: (1) age 18-84, (2) diagnosed with type 2 diabetes, (3) has poorly controlled diabetes (defined as HbA1c >7.5% for ages 18-69 and >8.5% for ages 70-84) (4) has a compelling indication for an SGLT-2i or GLP-1RA (including cardiovascular disease, kidney disease, heart failure, or obesity), who are not already prescribed one of these therapies. Exclusion Criteria: Patients: - We will exclude individuals with end stage renal disease, dementia, type I diabetes, or an EHR indicator of hospice care. - We will also exclude patients who are not on the MGH diabetes registry, because patients who are excluded from the registry typically have a clinical reason for alternative diabetes goals or care plans. Physicians: - Providers will be excluded if they are involved in the design or conduct of this study (e.g. Drs. Haff and Horn, and the peer PCPs delivering the study intervention). |
Country | Name | City | State |
---|---|---|---|
United States | Massachusetts General Hospital | Boston | Massachusetts |
Lead Sponsor | Collaborator |
---|---|
Brigham and Women's Hospital | National Institute on Aging (NIA) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Rate of prescriptions for SGLT-2i or GLP-1RA among eligible patients in each arm, compared across study arms | The study team will use electronic health record (EHR) prescribing data to identify prescriptions for SGLT-2i and GLP-1RA medications during the 6 month study intervention period among eligible patients. Rates of prescribing of these medications will be compared across study arms. | 6 months | |
Secondary | Rate of prescriptions for SGLT-2i or GLP-1RA medications among all patients with diabetes, compared across study arms | The study team will use EHR prescribing data to identify prescriptions for SGLT-2i and GLP-1RA medications during the 6 month study intervention period among all patients with diabetes cared for by study PCPs. Rates of prescribing of these medications will be compared across study arms. | 6 months | |
Secondary | Change in Hemoglobin A1c (A1c) over the 6-month intervention period among eligible patients, compared across study arms | The study team will use EHR data to calculate a change in A1c among eligible patients. The baseline A1c will be the last A1c measured within the 6-months prior to intervention start, and the follow-up A1c will be the last A1c measured in the 6-month intervention period. This change in A1c will be compared across study arms. | 6 months |
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