Increased Dysglycemia Screening With EHR-Supported Intervention
Intervention-based dysglycemia screening improved outcomes in study participants at 5 urban clinics.
HealthDay News — Implementation of an intervention, including electronic health record (EHR)-based decision support and training for use of the American Diabetes Association guidelines for dysglycemia screening, is associated with an increase in appropriate dysglycemia screening, according to a study published online in Diabetes Care.
Jeanine B. Albu, MD, from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues identified 40,456 adults without type 2 diabetes or recent screening with a face-to-face visit in 5 urban clinics using EHR data. The authors examined the impact of the intervention (system-wide primary care diabetes management program, including targeted guidelines for type 2 diabetes and dysglycemia screening) on trends in 3 outcomes: the monthly proportion of eligible patients receiving dysglycemia testing; 2 negative comparison conditions; and the yield of undiagnosed dysglycemia among those tested.
The researchers found that the baseline monthly proportion of eligible patients receiving testing varied from 7.4% to 10.4%. Screening doubled after the intervention (mean increase: +11%; 95% CI, 9-13). The proportion of ineligible patients also increased (+5%; 95% CI, 3-8), with no change seen in cholesterol testing (+0%; 95% CI, -0.02-0.05). Both before and after the intervention, about 59% of test results in eligible patients showed dysglycemia.
"Implementation of a policy for systematic dysglycemia screening including formal training and EHR templates in urban academic primary care clinics resulted in a doubling of appropriate testing and the number of patients who could be targeted for treatment to prevent or delay type 2 diabetes," the authors write.
Disclosures: Two authors disclosed financial ties to the pharmaceutical industry.
Albu JB, Sohler N, Li R, et al. An interrupted time series analysis to determine the effect of an electronic health record-based intervention on appropriate screening for type 2 diabetes in urban primary care clinics in New York City [published online July 2017]. Diabetes Care. doi:10.2337/dc16-2133