Studies
Individualized electronic decision support and reminders to improve diabetes care in the community: COMPETE II randomized trial. CMAJ 2009;18(1-2):37-44.
Author: Holbrook A, Thabane L, Keshavjee K, Dolovich L, Bernstein B, Chan D, Troyan S, Foster G, Gerstein H, for the COMPETE II Investigators
Intervention Type:
Disease State:
Study Objective
To rigorously evaluate whether a diabetes-specific computerized decision-support system, shared between patient and primary care provider, could improve the quality of diabetes management in primary care.
Methods
In this pragmatic randomized trial, we randomly assigned adult primary care patients with type 2 diabetes, cared for in practices already using electronic medical records to receive the intervention or usual care. The intervention involved shared access by the primary care provider and the patient to a Web-based, colour-coded diabetes tracker, which provided sequential monitoring values for 13 diabetes risk factors, their respective targets and brief, prioritized messages of advice.
Key Findings
- A shared electronic decision-support system to support the primary care of diabetes improved the process of care and some clinical markers of the quality of diabetes care.
Implications for Drug Safety and Effectiveness Research
The degree of policy rigour that has been applied to drugs must be applied to broader e-health interventions, to understand where clinical computerized decision support can be effective for patient-important outcomes and what will be required to make it cost-effective.