Educational Materials for Type 2 Diabetes

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of British Columbia

Disqualifiers: Not registered, Fewer than 100 patients

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if special educational materials for doctors and nurse practitioners can change how they treat older adults with type 2 diabetes in British Columbia, Canada. It examines whether these materials affect the number of patients prescribed certain diabetes medications, such as sulfonylureas or insulin, when their blood sugar levels are already controlled (A1C below 7%). Nurse practitioners and family physicians who treat many patients and have enrolled in the Portrait Online program are ideal participants. The trial compares two groups: one receiving the materials early and another receiving them later. As an unphased trial, this study offers participants the opportunity to contribute to improving diabetes care practices.

Do I need to stop taking my current medications for this trial?

The trial does not specify whether participants need to stop taking their current medications.

What prior data suggests that these educational materials are safe for use in clinical practice?

Research has shown that educational tools like prescribing portraits and therapeutic letters are well-received by doctors and nurses. These tools assist in making better decisions for older adults with type 2 diabetes by reducing unnecessary use of certain diabetes medications.

These materials do not directly affect patients' health, as they serve educational purposes. They guide healthcare providers in making safer prescribing choices. No negative effects from using these materials have been reported, making them a safe way to enhance diabetes care for older adults. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how educational materials, specifically a prescribing portrait and therapeutics letter, can impact the management of Type 2 diabetes. Unlike traditional treatments that focus on medications like metformin or insulin to control blood sugar levels, this approach aims to empower patients by enhancing their understanding and management of the condition. By providing timely and accessible information, these materials could improve adherence to treatment plans and potentially lead to better health outcomes. The trial's unique timing approach, with one group receiving information earlier than the other, may also reveal the importance of timing in patient education.

What evidence suggests that these educational materials are effective for changing prescribing practices in type 2 diabetes?

Research has shown that personalized prescribing guides and informative letters can influence how doctors prescribe medications. In this trial, Group 1 will receive the prescribing portrait and therapeutics letter early, while Group 2 will receive them after a delay. These tools have reduced the overuse of diabetes medications in older adults with type 2 diabetes who already have well-controlled blood sugar levels. Studies have found that excessively low blood sugar levels can increase the risk of harm in older adults, including higher death rates among those at high risk of heart problems. By providing tailored information, these materials help doctors make safer prescribing decisions, potentially reducing the unnecessary use of drugs like sulfonylureas and insulin when blood sugar is already well-managed. This approach aims to balance effective diabetes management with minimizing risks. ^{1 2 3 5 6}

Who Is on the Research Team?

Colin Dormuth, ScD

Principal Investigator

University of British Columbia

Are You a Good Fit for This Trial?

This trial is for nurse practitioners and family physicians in British Columbia, Canada. It's designed to see if educational materials affect their treatment choices for older adults with type 2 diabetes, specifically regarding the prescription of sulfonylureas or insulin when A1C levels are below 7%.

Inclusion Criteria

For physicians: defined as a General Practitioner or Family Physician - Emergency Medicine according to the BC Ministry of Health's Medical Services Plan with a license status of private practice, temporary license, salaried, or post graduate

Had ≥100 patients with prescriptions filled at a community pharmacy in 2022

Registered with the College of Physicians and Surgeons of BC or BC College of Nurses and Midwives as a nurse practitioner

Exclusion Criteria

Physicians who were not classified as a General Practitioner or Family Practice - Emergency Medicine according to the BC Ministry of Health's Medical Services Plan with a license status of private practice, temporary license, salaried, or post graduate

Had fewer than 100 patients with prescriptions filled at a community pharmacy in 2022

Not registered with the College of Physicians and Surgeons of BC or BC College of Nurses and Midwives as a nurse practitioner

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Group 1 clinicians receive prescribing Portraits and Therapeutics Letter on January 15, 2024, and Group 2 receives them on October 15, 2024

9 months

Digital access to materials

Follow-up

Participants are monitored for changes in prescribing patterns and patient outcomes

9 months

What Are the Treatments Tested in This Trial?

Interventions

• Portrait + Therapeutics Letter

Trial Overview The study tests whether a personalized prescribing portrait and therapeutics letter can influence clinicians' prescribing habits compared to usual care. Participants are split into two groups: one receives the intervention early while the other gets it later (Delayed Group).

How Is the Trial Designed?

Group I: Group 2 - Delayed Control Experimental Treatment 1 Intervention

This group received the prescribing portrait and therapeutics letter on October 15, 2024 (9 months after Group 1 received the materials). The materials were uploaded to the Portrait Online interface on this date, and recipients were sent an email notifying them of the new material available.

Group II: Group 1 - Early Portrait + Letter Experimental Treatment 1 Intervention

This group received the prescribing portrait and therapeutics letter on January 15, 2024. The materials were uploaded to the Portrait Online interface on this date, and recipients were sent an email notifying them of the new material available.

Who Is Running the Clinical Trial?

University of British Columbia

Lead Sponsor

Trials

1,506

Recruited

2,528,000+

Ministry of Health, British Columbia

Collaborator

Trials

11

Recruited

15,600+

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06976541

Utilization Study and Evaluation of Educational Intervention ... This study is a randomized trial testing the effectiveness of personalized prescribing Portraits and Therapeutics Letters to reduce the over utilization of ...

2. ti.ubc.ca ti.ubc.ca/2024/01/15/minimizing-harms-of-tight-glycemic-control-in-older-people-with-type-2-diabetes/

Minimizing harms of tight glycemic control in older people with ... This Portrait was accompanied by the Therapeutics Letter: Minimizing harms of tight glycemic control in older people with type 2 diabetes.

3. ti.ubc.ca ti.ubc.ca/2024/10/09/151-minimizing-harms-of-tight-glycemic-control-in-older-people-with-type-2-diabetes/

[151] Minimizing harms of tight glycemic control in older ... This Therapeutics Letter evaluates the risks of tight glycemic control in older adults with T2DM, focusing on deprescribing diabetes medications in those over ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1551714421001981

Individualized prescribing portraits to reduce inappropriate ... REDONNA is a mixed-methods randomized study testing the effectiveness of individualized prescribing Portraits to reduce inappropriate initiation of opioid ...

5. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK598554/

Glycemic Targets in Type 2 Diabetes - Therapeutics Letter A glycemic target of < 6% compared to a target of 7 to 7.9% caused increased mortality in type 2 diabetics who were at high risk of cardiovascular events.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5721968/

Antidiabetic medications and mortality reduction It was widely believed that antidiabetic medications should improve the macrovascular (such as mortality and myocardial infarction) as well as microvascular ...