PCORI funds Dissemination and Implementation projects to increase awareness and promote the use of PCORI research findings to improve healthcare practices and health outcomes. This project is proposing to conduct dissemination and implementation activities for the results of the research project: 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.
COVID-19-Related Project Enhancement
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
This project is in progress
What were the results from the original PCORI-funded research study?
Many people with diabetes check their blood sugar by pricking their 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 their blood sugar level. In the original study, the research team assigned people with type 2 diabetes who don’t need insulin treatment to one of three groups by chance. One group checked their blood sugar once a day. The second group checked their blood sugar once a day and got messages about their results. The third group didn’t check their blood sugar level. After a year, the study found no differences in blood sugar levels or quality of life between people who did or didn’t check their blood sugar.
Why is this research finding important?
Checking blood sugar is painful and takes time, and supplies are costly. Patients who may not need to test their blood sugar can avoid the inconvenience of daily testing and focus their attention on better ways to improve their health.
What is the goal of this project?
The project team created a program, Rethink the Strip, to help primary care clinicians, patients, and health insurers work on stopping daily blood sugar testing for people with type 2 diabetes who don’t need insulin. The team wants to improve the program before releasing it nationally.
What is the project team doing?
The project team is developing strategies for Rethink the Strip that include
- Meetings at each clinic to present the results of the original study
- Webinars for clinicians
- Educational materials for clinicians and patients
- Quarterly review of how many patients at each clinic are prescribed daily blood sugar testing, with report cards and feedback
The project team is testing Rethink the Strip in three clinics in North Carolina for six months. After getting feedback from clinic staff and patients, the team is revising the strategies and materials. They will then work with 17 new clinics in North Carolina to help them use the program for 18 months.
How is the team evaluating this project?
The project team is monitoring
- How many clinicians and diabetes educators trained through the project
- Whether clinicians who get training prescribe blood sugar testing less often for patients with type 2 diabetes who don’t need insulin treatment
In interviews and focus groups, the project team is asking patients, clinicians, and diabetes educators about their experience with Rethink the Strip.
How is the team involving patients and others in making sure the findings reach people who can use them?
Patients, state and national diabetes groups, physician associations, and health insurers in North Carolina are working with the project team to develop the materials, share them, and monitor the results.
Learn more about PCORI’s Dissemination and Implementation program here.
Related PCORI-funded Research Project
Note: Results from the original project have completed PCORI's Peer Review and are available here.
A Diabetes Home Test Can Be a Waste of Time and Money
"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.
Implementation of PCORI-Funded Patient-Centered Outcomes Research Results (Limited PCORI Funding Announcement)