Impact Evaluation of the Therapeutic Initiative's Type 2 Diabetes in Older Adults Portrait and Therapeutics Letter

Condition(s) studied

Investigational drug(s) / intervention(s)

Portrait + Therapeutics Letter: In the context of audit and feedback interventions, Portrait is a document produced by the physician organization Therapeutics Initiative that provides personalized prescribing feedback for BC clinicians. Portraits are used as a practice resource tool for reflection on prescribing patterns. Each Portrait topic provides data of individual prescriber's prescribing practice, benchmarks or targets, a succinct review of the best-available evidence on the topic, and recommendations for future action. The Therapeutics Letter is a standalone publication that details identified problematic therapeutic issues in a brief, simple and practical manner. Therapeutics letters include a systematic literature review on a clinical topic, and provide reference for the data presented in the Portraits.

Study summary

The goal of this randomized trial is to learn if educational materials and personalized prescribing portraits change how clinicians in British Columbia (BC), Canada treat older adults with type 2 diabetes (T2DM). The main question the investigators aim to answer is:

• Did a personalized prescribing portrait and therapeutics letter lead to a change in the number of older adults prescribed sulfonylureas or insulin when they have glycated hemoglobin (A1C) levels below 7%, compared to usual care.

Study participants are nurse practitioners and family physicians actively practicing in BC, Canada. Participants registered on the project website, Portrait Online, to receive their digital prescribing portraits. Participants were randomized to either receive educational materials in the Early Group or in the Delayed Group. Using administrative health data, the prescribing of those in the Early Group will be compared to those in the Delayed Group to see if the materials influenced their prescribing.

Eligibility

Primary outcome measure(s)

• Difference in change from baseline for mean number of patients with A1C < 7% taking a study drug between Group 1 and Group 2 — 9 months
  The primary outcome is the difference in the change from baseline in the mean number of patients with A1C ≤ 7% taking a sulfonylurea or insulin at 9-months after the early release of the Portrait and Therapeutics Letter (intention-to-treat analysis). The investigators will use a 2-sample t-test, with an alpha of 0.05 to test for statistical significance.

Trial sites (1)

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