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Related Concept Videos

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Methods Of Healthcare Delivery System01:26

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Healthcare Associated Infections II: Preventive Measures01:22

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Secondary Healthcare System01:11

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Related Experiment Video

Updated: May 17, 2025

The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
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Re-Think the Strip: de-implementing a low value practice in primary care.

Katrina E Donahue1,2, Marcella H Boynton3, Jennifer Leeman4

  • 1Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. kdonahue@med.unc.edu.

BMC Primary Care
|April 4, 2025
PubMed
Summary
This summary is machine-generated.

De-implementing self-monitoring of blood glucose (SMBG) in type 2 diabetes (T2DM) is feasible in primary care. While SMBG prescriptions decreased, the Re-Think the Strip intervention showed limited impact, especially for newly diagnosed patients.

Keywords:
De-implementationDiabetesGlucose monitoringImplementation and disseminationPractice-based research

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Area of Science:

  • Primary Care Research
  • Diabetes Management
  • Health Services Research

Background:

  • Self-monitoring of blood glucose (SMBG) offers limited value for most patients with non-insulin treated type 2 diabetes (T2DM).
  • The Re-Think the Strip (RTS) initiative aimed to de-implement SMBG in primary care for T2DM patients not on insulin.

Purpose of the Study:

  • To evaluate the effectiveness and implementation of the RTS multi-component de-implementation strategy.
  • To assess changes in SMBG prescribing practices in primary care settings.

Main Methods:

  • A pre-post study design was employed across 20 intervention and 34 comparison primary care clinics.
  • De-implementation strategies were applied over 12 months, with an 18-month follow-up period.

Main Results:

  • An overall decrease in the odds of receiving prescriptions for diabetes testing supplies was observed (OR 0.96).
  • No statistically significant difference in prescribing rates was found between intervention and comparison clinics.
  • A small intervention effect was noted in sensitivity analyses for newly diagnosed or newly assigned patients (OR 0.97).

Conclusions:

  • De-implementation of SMBG is feasible within primary care practices.
  • The RTS strategy demonstrated limited effectiveness, potentially influenced by external factors like the COVID-19 pandemic and baseline prescribing rates.
  • Newly diagnosed or new patients may represent a more receptive population for SMBG de-implementation efforts.