Project Details - Ongoing
- Grant Number:R18 HS026172
- AHRQ Funded Amount:$1,170,588
- Principal Investigator:
- Project Dates:9/1/2018 to 6/30/2021
- Care Setting:
- Medical Condition:
- Type of Care:
- Health Care Theme:
Prediabetes affects 86 million adults in the United States. Intensive lifestyle interventions (ILI) and metformin are safe and effective treatments to prevent or delay diabetes in adults with prediabetes and obesity. Despite being included in clinical guidelines, these treatments are rarely used, and few studies have explored how to promote their uptake in clinical practice. Clinical decision support (CDS) that uses electronic systems to create tailored recommendations for evidence-based clinical care is a possible approach for increasing adoption of ILI and metformin in primary care. While CDS is known to improve the delivery of other preventive health services, it has not been definitively studied for ILI and metformin.
This study will develop the novel Prevent Diabetes Mellitus Clinical Decision Support (PreDM CDS) intervention and evaluate its impact on clinical outcomes, healthcare processes, and associated costs for community health center patients with prediabetes obesity. PreDM CDS will engage primary care providers and clinical staff to deliver the following intervention components: 1) a decision aid about diabetes prevention developed by the project team, 2) an EHR referral to community-based ILI that meets recommended program requirements, and 3) a prompt for providers to consider prescribing metformin. Clinicians will receive monthly feedback about their use of the PreDM CDS through an existing dashboard. The project will be implemented at the AllianceChicago Health Center Controlled Network, which serves a predominantly minority population of inner-city and low-income individuals, who are at high risk for developing diabetes.
The specific aims of this project are as follows:
- To design the PreDM CDS.
- To test the effectiveness of the PreDM CDS at inducing weight loss and improving other cardiometabolic markers.
- To examine the reach, adoption, implementation, maintenance, and costs of the PreDM CDS.
The project team hypothesizes that PreDM CDS will result in significantly greater weight loss and improvements in other cardiometabolic markers among patients with prediabetes. If proven effective, use of PreDM CDS can be expanded to the 33 community health centers in the AllianceChicago Network.