Study of a Diabetes Prevention Patient Activation Clinical Decision Support Tool
- Conditions
- PreDiabetesLifestyle, HealthyActivation, Patient
- Interventions
- Behavioral: Diabetes Prevention Patient Activation Clinical Decision Support Tool
- Registration Number
- NCT06358261
- Lead Sponsor
- Johns Hopkins University
- Brief Summary
The investigators overarching goal is to increase the percentage of patients engaging in diabetes prevention activities to reduce the incidence of diabetes. The investigators objective is to design and pilot test a prediabetes clinical decision support (CDS) tool in the electronic health record (EHR) that will assess the patient's activation level based on responses to a questionnaire. Based on the patient's assessed level of activation, the tool will generate several communication recommendations to guide clinicians in conversations related to prediabetes/lifestyle change and tailor recommendations about available resources (e.g., care manager, health coach, DPP) to support patient activation.
- Detailed Description
Patient activation, which incorporates elements of self-efficacy and readiness to change, is particularly important in managing conditions like pre-diabetes, where the mainstay of treatment is behavioral lifestyle change and self-management. Unfortunately, Primary Care Physicians (PCPs) often do not have adequate training on how to promote patient activation. Traditionally, patient decision aids are used in shared decision-making to help elicit patient preferences and guide treatment options. However, the guides primarily focus on reviewing treatment options rather than increasing patient activation, which is key to successful and efficient behavioral counseling. The Patient Activation Measure (PAM) is a widely used and validated patient-reported outcome measure for assessing patient activation. Studies have demonstrated that using PAM to tailor care to a patient's activation level decreased health service utilization while improving clinical outcomes like blood pressure and self-management behaviors.
The investigators overarching goal is to increase the percentage of patients engaging in diabetes prevention activities to reduce the incidence of diabetes. The investigators objective is to design and pilot test a pre-diabetes clinical decision support (CDS) tool in the electronic health record (EHR) that will assess the patient's activation level based on responses to a questionnaire. Based on the patient's assessed level of activation, the tool will generate several communication recommendations to guide clinicians in conversations related to pre-diabetes/lifestyle change and tailor recommendations about available resources (e.g., care manager, health coach, DPP) to support patient activation.
Recruitment & Eligibility
- Status
- ENROLLING_BY_INVITATION
- Sex
- All
- Target Recruitment
- 100
- prediabetes
- patient at Johns Hopkins General Internal Medicine clinic at Green Spring Station
- MyChart account
- history of diabetes
- non-English speaker
- severe intellectual disability or psychiatric comorbidities
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention Arm (DPACT) Diabetes Prevention Patient Activation Clinical Decision Support Tool In this arm, patients will have at least 2 visits with the participants primary care doctor. Before each visit, participants will complete a patient activation survey. Results of the survey will be shared with the primary care doctor and entered into the medical record so that the Diabetes Prevention Patient Activation Clinical Decision Support Tool can be used by the participants doctor during the visit to discuss lifestyle management.
- Primary Outcome Measures
Name Time Method patient activation as assessed by the Patient Activation Measure Survey (PAM) baseline, 6 months measured by Patient Activation Measure (PAM) survey, a 13-item scale with 4 Likert response,s and scores ranging from 0 to 100 (higher score means higher activation level)
- Secondary Outcome Measures
Name Time Method percent of participants who make diet changes baseline, 6 months measured using survey developed by study team will assess what diet changes participants have made
number of participants prescribed metformin baseline, 6 months measured using electronic health record data
number of participants referred to Diabetes Prevention Program baseline, 6 months measured using electronic health record data
change in amount and frequency of physical activity baseline, 6 months measured using survey developed by study team will assess the change in amount and frequency of physical activity that participants have made
Trial Locations
- Locations (1)
Johns Hopkins Internal Medicine at Green Spring Station
🇺🇸Lutherville, Maryland, United States