Cluster randomised controlled trial of a theory-based multiple behaviour change intervention aimed at healthcare professionals to improve their management of type 2 diabetes in primary care

Justin Presseau, Joan Mackintosh, Gillian Hawthorne, Jill J. Francis, Marie Johnston, Jeremy M. Grimshaw, Nick Steen, Tom Coulthard, Heather Brown, Eileen Kaner, Marko Elovainio, Falko F. Sniehotta
2018 Implementation Science  
National diabetes audits in the UK show room for improvement in the quality of care delivered to people with type 2 diabetes in primary care. Systematic reviews of quality improvement interventions show that such approaches can be effective but there is wide variability between trials and little understanding concerning what explains this variability. A national cohort study of primary care across 99 UK practices identified modifiable predictors of healthcare professionals' prescribing,
more » ... and foot examination. Our objective was to evaluate the effectiveness of an implementation intervention to improve six guidelinerecommended health professional behaviours in managing type 2 diabetes in primary care: prescribing for blood pressure and glycaemic control, providing physical activity and nutrition advice and providing updated diabetes education and foot examination. Methods: Two-armed cluster randomised trial involving 44 general practices. Primary outcomes (at 12 months follow-up): from electronic medical records, the proportion of patients receiving additional prescriptions for blood pressure and insulin initiation for glycaemic control and having a foot examination; and from a patient survey of a random sample of 100 patients per practice, reported receipt of updated diabetes education and physical activity and nutrition advice.
doi:10.1186/s13012-018-0754-5 pmid:29720209 pmcid:PMC5930437 fatcat:ddbxk2vzsfa7jc6dbxpq6ksskm