Prevent Diabetes Mellitus (PreDM) Clinical Decision Support Intervention in Community Health Centers

Project: Research project

Project Details

Description

Eighty six million U.S. adults have prediabetes, and up to 70% of them will eventually develop diabetes. Large comparative effectiveness trials have established that intensive lifestyle interventions (ILI) and metformin are safe and effective treatments to prevent or delay diabetes in adults with prediabetes and overweight/obesity. Despite being included in expert clinical guidelines, these treatments are rarely used and few studies have explored how to promote their uptake in practice. One possible approach for increasing adoption of ILI and metformin in primary care includes clinical decision support (CDS), which uses electronic systems to create tailored recommendations for evidence-based clinical care. While a large body of evidence demonstrates that CDS can improve the delivery of other recommended preventive services, this approach has not been definitively studied for ILI and metformin. We plan to address this critical knowledge gap by developing and evaluating the Prevent Diabetes Mellitus Clinical Decision Support (PreDM CDS) intervention for community health center patients with prediabetes and overweight/obesity. This novel CDS engages the primary care team to deliver the following intervention components: 1) a decision aid about diabetes prevention developed by our group; 2) an EHR referral to community-based ILI programs that meet USPSTF requirements and are located in patients’ zip code; and 3) a prompt for clinicians to consider prescribing metformin. Clinicians will receive monthly feedback about their use of the PreDM CDS through an existing dashboard. By accomplishing the following specific aims, this definitive R18 study will test the potential for CDS to promote diabetes prevention and weight loss efforts in primary care. In Aim 1, we will develop the proposed intervention by translating narrative guidelines about ILI and metformin into CDS, while incorporating extensive feedback from the primary care team. Aim 2 is a pragmatic cluster randomiz
StatusFinished
Effective start/end date9/1/18 → 6/30/22

Funding

  • Agency for Healthcare Research and Quality (5R18HS026172-03)

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