A Primary Care, EHR- Based Strategy to Promote Safe and Appropriate Drug Use
Condition: Diabetes Mellitus Type I; Diabetes Mellitus Type II
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      This study seeks to evaluate a low-literacy strategy in a primary health care setting for
      promoting safe and effective prescription medication use among English and Spanish-speaking
      patients with diabetes.

      The investigators hypothesize that in comparison with patients receiving standard care, the
      patients that received the Electronic Health Record (EHR) strategy will 1) demonstrate better
      understanding of how to safely dose out their medication regimen; 2) have fewer discrepancies
      in their medication lists; 3) take their medication regimen more efficiently; 4) have greater
      adherence to their medication regimen.
    

Detailed description: 
      The strategy takes advantage of health information technology to assist patients with
      Medication Therapy Management (MTM) tasks, intervening with a set of low-literacy MTM printed
      tools triggered by the Electronic Health Record (EHR) in a primary health care clinic.
      Patients at the University of Illinois at Chicago (UIC) Medicine Clinic who are randomized to
      the intervention arm will be given three printed tools, one when they check in to the clinic
      and the other two when they check out. The Electronic Health Record (EHR) triggers the
      printing of these tools, and the receptionist hands them to the patient. Patients receive
      either English or Spanish language materials depending on the preference determined in the
      screening process and stored in their EHR.

      Specific Aims

        1. Refine and Field Test an EHR strategy for generating and distributing low literacy
           prescription information for English and Spanish-speaking patients

        2. Assess the process of the EHR intervention and its fidelity for providing prescription
           information for patients at the point of prescribing and dispensing medications.

        3. Evaluate the effectiveness of the EHR strategy to improve medication understanding,
           reconciliation, regimen consolidation, and adherence compared to standard care.

      In addition, we will be powered to also investigate our strategy's impact on intermediary
      clinical outcomes including systolic blood pressure, HbA1c, and LDL cholesterol.
    

Intervention name(s): EHR Based Strategy to promote Safe and Appropriate Drug Use
Intervention type(s): Other
Intervention description(s): The printed tools presented in the intervention include:
Medication Review: a consolidated list of the medications a patient is currently taking.
Medication Sheet: a medication information sheet, including simplified prescription instructions, for each medication that a patient is newly prescribed.
Medication List: a table that lists all medications taken by the patient and provides an orientation on how to best organize and simplify their medication regimen
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Diabetes