Utilization Study and Evaluation of Educational Intervention on HbA1c Testing
Utilization Study and Impact Evaluation of the Therapeutic Initiative's Prescribing Portrait and Therapeutics Letter on HbA1c Testing
1 other identifier
interventional
968
1 country
1
Brief Summary
The aim of this randomized trial is to learn if educational materials and personalized prescribing Portraits change the frequency of ordering HbA1c tests by clinicians in British Columbia, Canada. The main research question: To investigate the overall utilization patterns of HbA1c testing and evaluate the effectiveness of a personalized prescribing Portrait and educational materials to reduce over-utilization of HbA1c tests in diabetes management. Participants are nurse practitioners and family physicians actively practicing in British Columbia. Participants are registered for the online prescribing Portrait program on the Therapeutics Initiative website where they can access their digital prescribing Portraits. Participants were randomized to receive educational materials on the topic of HbA1c testing either in an Early Group (Group 1 or Arm A) or in a Delayed Group (Group 2 or Arm B). Using administrative health data, the ordering of HbA1c tests by those in the Early Group will be compared with those in the Delayed Group to see if the materials influence the frequency of ordering HbA1c tests. Group 3 (Arm C) will be a control group for Groups 1 and 2 and include participants who receive no intervention.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jan 2023
Longer than P75 for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
January 1, 2023
CompletedFirst Submitted
Initial submission to the registry
April 24, 2025
CompletedFirst Posted
Study publicly available on registry
May 16, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
March 31, 2026
CompletedStudy Completion
Last participant's last visit for all outcomes
May 1, 2027
ExpectedMay 28, 2025
May 1, 2025
3.2 years
April 24, 2025
May 21, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Intention-to-treat analysis
The primary outcome is the difference in the change from baseline in the mean number of HbA1c tests ordered per patient.
Assessed from 90 days before Jan 1, 2023 to 90 days after Dec 31, 2023 for Group 1. For Group 2, assessed from 90 days prior to Jan 1, 2024 to 90 days after Dec 31, 2024 (12 months + 180 days for both groups).
Secondary Outcomes (1)
Intention-to-treat analysis
Assessed from 90 days before Jan 1, 2023 to 90 days after Dec 31, 2023 for Group 1. For Group 2, assessed from 90 days prior to Jan 1, 2024 to 90 days after Dec 31, 2024 (12 months + 180 days for both groups).
Study Arms (3)
Arm A (Group 1) - Early Portrait + Letter
EXPERIMENTALThis arm gained access to the prescribing portrait and Therapeutics Letter on March 31, 2025. The materials were uploaded to the Portrait program online portal on this date, and recipients who are registrants to the Portrait program were sent an email notifying them of the new material available.
Arm B (Group 2) - Delayed control
EXPERIMENTALThis "delayed" control group will get access to the prescribing Portrait and Therapeutics Letter 12 months after Group 1 (March 31, 2026). The materials will be uploaded to the Portrait program online portal on this date, and recipients who are registrants to the Portrait program will be sent an email notifying them of the new material available.
Arm C (Group 3) - Non-Portrait users
NO INTERVENTIONThis group will not have access to the Portrait and Therapeutics Letter intervention because they are not registered with the Portrait program (i.e., non Portrait users).
Interventions
In the context of audit and feedback interventions, the prescribing Portrait is a document produced by the Therapeutics Initiative that provides personalized prescribing feedback for clinicians in British Columbia. Portraits are used as a practice resource tool for reflection on prescribing or test-ordering patterns. Each Portrait topic provides data of individual prescriber's ordering of HbA1c tests within 90 days of a previous test along with evidence-based benchmarks or targets. Prescribers are also given access to a succinct review of the best available evidence on the topic and recommendations for future action in the Therapeutics Letter, a stand-alone publication that details the evidence for the recommended practice in a brief and practical manner. Therapeutics Letters include a systematic literature review on a clinical topic, and provide references for the data presented in the prescribing Portraits.
In the context of audit and feedback interventions, the prescribing Portrait is a document produced by the Therapeutics Initiative that provides personalized prescribing feedback for clinicians in British Columbia. Portraits are used as a practice resource tool for reflection on prescribing or test-ordering patterns. Each Portrait topic provides data of individual prescriber's ordering of HbA1c tests within 90 days of a previous test along with evidence-based benchmarks or targets. Prescribers are also given access to a succinct review of the best available evidence on the topic and recommendations for future action in the Therapeutics Letter, a stand-alone publication that details the evidence for the recommended practice in a brief and practical manner. Therapeutics Letters include a systematic literature review on a clinical topic, and provide references for the data presented in the prescribing Portraits.
Eligibility Criteria
You may qualify if:
- Physicians and nurse practitioners:
- Registered with the College of Physicians and Surgeons of B.C. or BC College of Nurses and Midwives as a nurse practitioner.
- For physicians: defined as a General Practitioner or FP - Emergency Medicine according to the B.C. Ministry of Health's Medical Services Plan (MSP) with a licence status of private practice, temporary licence, salaried, or post graduate.
- Had ≥100 patients with prescriptions filled at a community pharmacy in 2022.
You may not qualify if:
- Not registered with the College of Physicians and Surgeons of B.C. or BC College of Nurses and Midwives as a nurse practitioner.
- Physicians who were not classified as a General Practitioner or Family Practice - Emergency Medicine according to the B.C. Ministry of Health's Medical Services Plan (MSP) with a licence status of private practice, temporary licence, salaried, or post graduate.
- Had fewer than 100 patients with prescriptions filled at a community pharmacy in 2023.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Therapeutics Initiative - Dept of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia
Vancouver, British Columbia, V6T 1Z3, Canada
Related Links
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Colin Dormuth, ScD
University of British Columbia
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- PARTICIPANT
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- SEQUENTIAL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Associate Professor
Study Record Dates
First Submitted
April 24, 2025
First Posted
May 16, 2025
Study Start
January 1, 2023
Primary Completion
March 31, 2026
Study Completion (Estimated)
May 1, 2027
Last Updated
May 28, 2025
Record last verified: 2025-05
Data Sharing
- IPD Sharing
- Will not share
The data access agreement for the Therapeutics Initiative does not permit sharing of IPD.