Please select the eligibility criteria that correspond to the clinical trial below.
Title: Reducing Unnecessary Use of Heavily Marketed Medicines: A Randomized Controlled Trial of Computerized Prescribing Alerts and Clinician Education
Brief Summary: Prescribing decisions by clinicians are often thought to be simple: a patient's clinical problem leads a prescriber to choose the optimal treatment. However, many factors other than the patient's condition affect prescribing decisions, including the marketing of pharmaceuticals. Clinicians are subjected to direct "detailing" by representatives of the pharmaceutical industry, advertisements in medical journals and requests for specific treatments from patients, who are increasingly exposed to direct-to-consumer (DTC) advertising. These influences, often based on biased or inaccurate information, contribute to a variety of problems in prescribing, including the unnecessary use of expensive, heavily marketed medications.

Overcoming these influences requires innovative approaches. The movement toward widespread adoption of electronic health records (EHRs) and electronic prescribing presents new opportunities to educate both clinicians and patients at the time of medication prescribing. This project, endorsed by the AHRQ-supported Centers for Education and Research on Therapeutics (CERTs; www.certs.hhs.gov) and the U.S. Food and Drug Administration (FDA), aims to test the effectiveness of computerized prescribing alerts and state-of-the-art educational outreach to reduce the unnecessary use of heavily marketed medications. A second goal is to improve clinicians' knowledge of industry marketing practices, so that they can more effectively assess information provided by drug companies. Thus, the study has two specific aims:

Specific Aim 1: To assess whether computerized prescribing alerts linked electronically to patient educational material can reduce prescribing of heavily marketed medications.

Specific Aim 2: To assess whether group academic detailing increases clinicians' knowledge about industry marketing practices and increases the effect of prescribing alerts.


Options:
A: Inclusion Criteria for Midwives:

* Wuqu' Kawoq's catchment area
* Bilingual speakers of Spanish and Kaqchikel Maya
* Willing to give consent and be trained on the mHealth technology
* Must be under the age of 65
* Must be 18 years-old or older

Exclusion Criteria for Midwives:

* Outside Wuqu' Kawoq's catchment area
* Not a bilingual speaker of Spanish and Kaqchikel Maya
* Over the age of 65
* Under the age of 18
* Unable to give consent and be trained on the mHealth technology

Inclusion Criteria for Pregnant Women:

* Must be 18 years-old or older
* Must be pregnant
* Must have a midwife that has been recruited for the study
* Bilingual speakers of Spanish and Kaqchikel Maya
* Willing to give consent

Exclusion criteria for pregnant women

* Under 18 years of age
* Not pregnant
* Does not have a midwife in the study
* Is not bilingual in Spanish and Kaqchikel Maya
* Unable to consent
B: Inclusion Criteria:

* Internal medicine clinicians

Exclusion Criteria:

* none
C: Inclusion Criteria:

* age 18 years or older,
* self-identified Hispanic ethnicity,
* diagnosis of T2D,
* HbA1c \>7.5%, and
* provider approval given for patient participation

Exclusion Criteria:

* inability to consent,
* pregnant or planning to become pregnant in the next year,
* taking glucocorticoid therapy, or
* having serious psychiatric or medical complications (e.g., late stage diabetes complications, seizures, dementia, psychiatric hospitalization) that would prevent participation in study activities.
D: Inclusion Criteria:

* Physicians are eligible for inclusion if they are general practitioners or family physicians in full-time (≥ 4 days/week), fee-for-service practice in Quebec-patients where the study physician has written or dispensed psychotropic medications

Exclusion Criteria:

* under 65 years old

Answer: B