Diabetes Mellitus, Hypoglycemia
Conditions
Keywords
Hypoglycemia, Diabetes mellitus, Clinical decision support, Electronic health records
Brief summary
Hypoglycemia (HG) is common and can be dangerous in diabetes mellitus, so identifying patients at risk may lead to useful preventive strategies and improved quality of care and health outcomes. This study will test the implementation of a computerized alert tool for clinicians.
Detailed description
Diabetes mellitus is one of the most common non-communicable diseases worldwide and is a major cause of morbidity and mortality. An estimated 346 million people had diabetes in 2011, and diabetes is predicted to become the seventh leading cause of death in the world by the year 2030. In the United States, the incidence of diabetes nearly tripled between 1990 and 2010, with 1.9 million new cases diagnosed in 2010. Hypoglycemia (HG) is recognized as a limiting factor in optimal glycemic management of patients with diabetes. This potentially costly condition, occurring in approximately 20% to 60% of patients who receive oral medications for diabetes, threatens patient safety, quality of life, and potentially, cardiovascular health. Investigators have identified risk factors for HG, built a risk calculator for use by clinicians, integrated the calculator into the G3 electronic medical record system, and demonstrated our ability to collect data about outcomes. In this project, investigators studied the outcomes of implementing the risk calculator tool into clinical practice in ambulatory primary care. The findings and tools developed from this project will promote improved patient safety and medical care for diabetes.
Interventions
The alert tool displays the risk of hypoglycemia for outpatients with diabetes mellitus.
Sponsors
Study design
Intervention model description
Clinicians were randomized to see, or not see, a clinical decision-support alert tool when evaluating outpatients with diabetes mellitus
Eligibility
Inclusion criteria
The study included clinicians who were scheduled to provide primary care during the four-month intervention period. Inclusion Criteria for patients: * Being at least 21 years of age * Have been prescribed or dispensed a drug for diabetes mellitus
Exclusion criteria
for patients: N/A
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with hypoglycemia during the study period | Five-month follow-up period | Participants with hypoglycemia had blood glucose level less than 70 mg/dL |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with changes to prescriptions for diabetes or antibiotics: new, refilled, changed, or discontinued | Five-month follow-up period | Prescriptions for insulin and sulfonylurea drugs are assessed |
Other
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with inpatient or outpatient medical encounters | Five-month follow-up period | Includes emergency encounters |
| Number of participants undergoing patient education related to diabetes | Five-month follow-up period | Text analysis of medical encounter notes |
| Number of A1c, glucose, and creatinine blood tests | Five-month follow-up period | Mean and SD |