Project Summary
PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.
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This PCORI-funded implementation project is working to phase out daily blood sugar testing for patients with type 2 diabetes who don’t need insulin, based on a recent study showing that daily testing doesn’t help these patients to manage their diabetes or improve their quality of life. |
If you have type 2 diabetes, it’s important to keep the amount of glucose, or sugar, in your blood at a healthy level. People with type 2 diabetes should get an HbA1c test every few months. An A1c test measures average blood sugar levels over the past three months. Many patients also check their blood sugar at home each day. But most patients with type 2 diabetes who don’t need insulin can avoid the discomfort, expense, and time of testing blood sugar each day. |
What is the goal of this implementation project?
Many people with diabetes test their blood sugar daily. Testing involves pricking the finger with a small needle, putting a drop of blood on a test strip, and putting the strip inside a hand-held meter that shows the blood’s sugar level. But a PCORI-funded research study found that people with type 2 diabetes who don’t use insulin didn’t benefit from daily self-testing. Based on this and other research, the project team created a program called Re-Think the Strip. The program aims to increase clinician knowledge about daily blood sugar testing and reduce unnecessary self-testing for patients with type 2 diabetes who don’t use insulin. This project is putting Re-Think the Strip in place in several North Carolina clinics.
What will this project do?
The project team is first helping three clinics in North Carolina to adopt Re-Think the Strip. Staff and patients at these sites are providing feedback to help the team revise the program as needed. The project team is then working with 17 more clinics to help them put the program in place.
The Re-Think the Strip program includes:
- Meetings with a trained nurse practice facilitator at each clinic to discuss the results of the research on daily blood sugar testing, review case studies, conduct role-playing activities, and answer questions
- Educational webinars for clinicians
- Educational materials for clinicians and patients
- Tools for clinicians to support the use of the program, such as user-friendly fact sheets, communication scripts, discussion guides, and frequently asked questions
The project team is also working with IT experts to gather data from health records and other sources to capture trends in prescriptions for daily blood sugar testing for patients with type 2 diabetes at each clinic. Every three months, clinicians receive report cards and feedback based on these data.
What is the expected impact of this project?
This project will demonstrate what’s required for routine use of a program to reduce unnecessary blood sugar self-testing for patients with type 2 diabetes who don’t use insulin.
Twenty primary care clinics are taking part in the Re-Think the Strip program. These clinics serve 4,400 patients with type 2 diabetes who don’t use insulin. The project evaluation will confirm that the program is working as intended.
More about this implementation project:
Stakeholders Involved in This Project*
*Stakeholders are engaged as neutral parties; their views about Re-Think the Strip may be positive or negative. |
Implementation Strategies
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Evaluation OutcomesTo document implementation:
To assess healthcare and health outcomes:
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COVID-19-Related Activities
Summary
Patients with type 2 diabetes go to clinic regularly to check their A1C levels. They also have a higher risk of serious complications from COVID-19. Patients may be unsure how to balance going to clinic with reducing risks of getting COVID-19.
With the enhancement, the team will explore strategies patients and their healthcare providers can use to stay on top of their blood glucose control as well as stay healthy and safe during the pandemic.
Our team will help providers answer common questions about diabetes care during COVID-19. This new information will be included in the Re-think the Strip Program.
Enhancement Award Amount: $466,752
More to Explore...
Media Mentions
A Diabetes Home Test Can Be a Waste of Time and Money
Carroll, "The Upshot" Blog, New York Times, March 11, 2019
Blog post author Aaron Carroll, who moderated a 2018 PCORI Annual Meeting plenary session about balancing benefits and potential harms of different treatment options, discusses the related study's finding that routine glucose monitoring may be unnecessary for people with Type 2 diabetes who are not on insulin. Study Principal Investigator Katrina Donahue, MD, MPH, was a presenter/panelist in that session.
Journal Citations
Related Journal Citations
Project Information
Key Dates
Study Registration Information
Initial PCORI-Funded Research Study
This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Does Daily Self-Monitoring of Blood Sugar Levels Improve Blood Sugar Control and Quality of Life for Patients with Type 2 Diabetes Who Do Not Use Insulin? -- The Monitor Trial