N/A
N=154
Advancing Insulin Prescribing in General Practice
Diabetes Mellitus
Bottom Line
View on ClinicalTrials.gov: NCT00593489 ↗Enrolled (actual)
154
Serious AEs
—
Results posted
Dec 2020
Primary outcome: Primary: Insulin Prescription Rate - the Number of Insulin-eligible Patients Per 12 Months Who Are Prescribed Insulin in Each Family Physician (FP) Practice — 2.28; 2.29 patients per year — p=0.96
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Basal Insulin Initiation Strategy (Other)
- Age
- Pediatric, Adult, Older Adult
- Sex
- All
- Sponsor
- London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
- Primary completion
- Mar 2010
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Insulin Prescription Rate - the Number of Insulin-eligible Patients Per 12 Months Who Are Prescribed Insulin in Each Family Physician (FP) Practice |
2.28; 2.29 | 0.96 |
| SECONDARY Mean A1C of Insulin-eligible Patient Per Family Physician Post-Workshop |
7.12; 7.20; 7.09; 7.15 | — |
| SECONDARY Mean Fasting Blood Glucose of Insulin-eligible Patients |
7.86; 7.89; 7.78; 7.82 | — |
| SECONDARY Percent of Insulin-eligible Patients With Intensification of Diabetes Management Per FP Post - Workshop |
31.59; 32.80 | — |
| SECONDARY Percentage of Patients at Target (A1C ≤ 7.0%) Per FP |
58.4; 55.95; 58.68; 57.58 | — |
| SECONDARY Percent of Patients at Target (A1C ≤ 6.5%) Per FP |
36.76; 36.62; 36.13; 36.61 | — |
| SECONDARY Change in "Insulin Prescription Rate" |
— | — |
| SECONDARY Glycemic Control (A1C) at Insulin Initiation, 3 and 6 Months Post Initiation |
8.82; 9.37; 8.32; 9.05; 7.97; 8.57 | — |
| SECONDARY Physician Score for Knowledge of Insulin Initiation & Titration |
15.5; 15.5; 16.3; 16.9 | — |
| SECONDARY Physician Score for Attitude Towards Insulin Initiation & Titration |
28.9; 29.7; 26.1; 27.3 | — |
| SECONDARY Physician Score for Self-efficacy of Insulin Initiation & Titration |
35.8; 35.7; 40.6; 39.6 | — |
Summary
Family Physicians, the subjects of this trial are reluctant to initiate insulin in patients with type 2 diabetes due to a lack of familiarity and comfort with this clinical strategy. This study will test the effectiveness of diabetes specialist consultation support, and community pharmacy insulin initiation support on the insulin prescribing behaviour of family physicians across Canada.
Eligibility Criteria
Inclusion Criteria
- Full time family physicians (FP) >25 hours per week in office
- Ability to generate a listing of patients with type 2 diabetes (T2DM) from their practice or billing records.
- Generation of a practice list of patients with T2DM
- A minimum of 50 patients with type 2 diabetes in their practice.
- Support the generation of a Diabetes Practice Profile prior to the deadline established
- A minimum of 6 insulin-eligible patients
- Attendance at the scheduled Workshop (if unable to attend the Workshop must be available to be educated and trained by diabetes nurse educator(DNE) using a Workshop DVD)
Exclusion Criteria
- FP does not attend Workshop or complete educational training using Workshop DVD with DNE guidance
- FPs who anticipate retiring within the post-intervention period, moving their practice to another city, or having locum coverage of their practice for more than 4 weeks during the post-intervention period
- FPs currently participating in a diabetes behaviour-change intervention trial
- FPs working in an academic environment
- FPs unlikely to comply with protocol, (uncooperative attitude, unlikelihood of completing the study).
Data sourced from ClinicalTrials.gov (NCT00593489). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.