Multifaceted intervention of assessment, education, and feedback increases likelihood of triple prescription fourfold over usual care
By Lori Solomon HealthDay Reporter
TUESDAY, March 14, 2023 (HealthDay News) — A coordinated, multifaceted intervention increases prescription of three groups of evidence-based therapies in adults with type 2 diabetes and atherosclerotic cardiovascular disease (CVD), according to a study published online March 6 in the Journal of the American Medical Association to coincide with the annual meeting of the American College of Cardiology, held from March 4 to 6 in New Orleans.
Neha J. Pagidipati, M.D., M.P.H., from the Duke Clinical Research Institute in Durham, North Carolina, and colleagues assessed the effect of a coordinated, multifaceted intervention of assessment, education, and feedback versus usual care on the proportion of adults with type 2 diabetes and atherosclerotic CVD prescribed all three groups of recommended, evidence-based therapies (high-intensity statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers [ACEIs or ARBs], and sodium-glucose cotransporter 2 inhibitors and/or glucagon-like peptide 1 receptor agonists [SGLT2 inhibitors and/or GLP-1RAs]). The analysis included 1,049 participants treated at 43 U.S. cardiology clinics (July 2019 through May 2022).
The researchers found that patients in the intervention group were more likely to be prescribed all three therapies (37.9 percent) versus individuals in the usual-care group (14.5 percent; adjusted odds ratio, 4.38) and were more likely to be prescribed each of the three therapies (adjusted odds ratios, 1.73, 1.82, and 3.11 for high-intensity statins, ACEIs or ARBs, and SGLT2 inhibitors and/or GLP-1RAs, respectively). No changes in atherosclerotic CVD risk factors were seen with the intervention.
“An absolute increase of 23.4 percent in prescriptions for all three recommended therapies in the intervention group versus the usual-care group, which was more than twice the improvement the trial was designed to detect, is clinically meaningful and, based on clinical trial evidence for these therapies, should result in a substantial improvement in patient outcomes over time,†the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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