Utilization Study and Evaluation of Educational Intervention on HbA1c Testing

Condition(s) studied

Investigational drug(s) / intervention(s)

Portrait + Therapeutics Letter - EARLY: In the context of audit and feedback interventions, the prescribing Portrait is a document produced by the Therapeutics Initiative that provides personalized prescribing feedback for clinicians in British Columbia. Portraits are used as a practice resource tool for reflection on prescribing or test-ordering patterns. Each Portrait topic provides data of individual prescriber's ordering of HbA1c tests within 90 days of a previous test along with evidence-based benchmarks or targets. Prescribers are also given access to a succinct review of the best available evidence on the topic and recommendations for future action in the Therapeutics Letter, a stand-alone publication that details the evidence for the recommended practice in a brief and practical manner. Therapeutics Letters include a systematic literature review on a clinical topic, and provide references for the data presented in the prescribing Portraits.

Portrait + Therapeutics Letter - DELAYED: In the context of audit and feedback interventions, the prescribing Portrait is a document produced by the Therapeutics Initiative that provides personalized prescribing feedback for clinicians in British Columbia. Portraits are used as a practice resource tool for reflection on prescribing or test-ordering patterns. Each Portrait topic provides data of individual prescriber's ordering of HbA1c tests within 90 days of a previous test along with evidence-based benchmarks or targets. Prescribers are also given access to a succinct review of the best available evidence on the topic and recommendations for future action in the Therapeutics Letter, a stand-alone publication that details the evidence for the recommended practice in a brief and practical manner. Therapeutics Letters include a systematic literature review on a clinical topic, and provide references for the data presented in the prescribing Portraits.

Study summary

The aim of this randomized trial is to learn if educational materials and personalized prescribing Portraits change the frequency of ordering HbA1c tests by clinicians in British Columbia, Canada.

The main research question: To investigate the overall utilization patterns of HbA1c testing and evaluate the effectiveness of a personalized prescribing Portrait and educational materials to reduce over-utilization of HbA1c tests in diabetes management.

Participants are nurse practitioners and family physicians actively practicing in British Columbia. Participants are registered for the online prescribing Portrait program on the Therapeutics Initiative website where they can access their digital prescribing Portraits. Participants were randomized to receive educational materials on the topic of HbA1c testing either in an Early Group (Group 1 or Arm A) or in a Delayed Group (Group 2 or Arm B). Using administrative health data, the ordering of HbA1c tests by those in the Early Group will be compared with those in the Delayed Group to see if the materials influence the frequency of ordering HbA1c tests. Group 3 (Arm C) will be a control group for Groups 1 and 2 and include participants who receive no intervention.

Eligibility

Primary outcome measure(s)

• Intention-to-treat analysis — Assessed from 90 days before Jan 1, 2023 to 90 days after Dec 31, 2023 for Group 1. For Group 2, assessed from 90 days prior to Jan 1, 2024 to 90 days after Dec 31, 2024 (12 months + 180 days for both groups).
  The primary outcome is the difference in the change from baseline in the mean number of HbA1c tests ordered per patient.

Trial sites (1)

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