ArticleBMJ open2012
Medication intensification in diabetes in rural primary care: a cluster-randomised effectiveness trial.
Article in BMJ open, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00403091 (Internet Intervention to Improve Rural Diabetes Care), which is not on this map. Cited by 11 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Internet Intervention to Improve Rural Diabetes Care
Who cites it
11 citing papers in PubMed, 5 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025Pooled it
- Quality improvement strategies for diabetes care: Effects on outcomes for adults living with diabetes.The Cochrane database of systematic reviews · 2023Pooled it
- Systematic review and narrative synthesis of computerized audit and feedback systems in healthcare.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Health professions digital education on clinical practice guidelines: a systematic review by Digital Health Education collaboration.BMC medicine · 2019Pooled it
- Digital Health Professions Education on Diabetes Management: Systematic Review by the Digital Health Education Collaboration.Journal of medical Internet research · 2019Pooled it
- Trial
- Implementing evidence-based practices in rural settings: a scoping review of theories, models, and frameworks.Frontiers in health services · 2024Article
- Patterns for Patient Engagement with the Hypertension Management and Effects of Electronic Health Care Provider Follow-up on These Patterns: Cluster Analysis.Journal of medical Internet research · 2021Article
- A Pharmacist and Health Coach-Delivered Mobile Health Intervention for Type 2 Diabetes: Protocol for a Randomized Controlled Crossover Study.JMIR research protocols · 2021Article
- Leveraging Providers' Preferences to Customize Instructional Content in Information and Communications Technology-Based Training Interventions: Retrospective Analysis of a Mobile Phone-Based Intervention in India.JMIR mHealth and uHealth · 2020Article
- Clinical inertia, reverse clinical inertia, and medication non-adherence in type 2 diabetes.Journal of endocrinological investigation · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo determine the effectiveness of a provider-based intervention to improve medication intensification among patients with diabetes.
designEffectiveness cluster-randomised trial. Baseline and follow-up cross-sections of diabetes physicians' patients.
settingEleven U.S. Southeastern states, 2006-2008.
participants205 Rural primary care physicians, 95 completed the study.
interventionMulticomponent interactive intervention including web-based continuing medical education (CME), performance feedback and quality improvement tools. PRIMARY OUTCOME MEASURES: Medication intensification, a dose increase of an existing medication or the addition of a new class of medication for glucose, blood pressure and lipids control on any of the three most recent office visits.
resultsOf 364 physicians attempting to register, 102 were randomised to the intervention and 103 to the control arms; 95 physicians (intervention, n=48; control, n=47) provided data on their 1182 of their patients at baseline (intervention, n=715; control, n=467) and 945 patients at follow-up (intervention, n=479; control, n=466). For A1c control, medication intensification increased in both groups (intervention, pre 26.4% vs post 32.6%, p=0.022; control, pre 24.8% vs post 31.1%, p=0.033) (intervention, adjusted OR (AOR) 1.37; 95% CI 1.06 to 1.76; control, AOR 1.41 (95% CI 1.06 to 1.89)); however, we observed no incremental benefit solely due to the intervention (group-by-time interaction, p=0.948). Among patients with the worst glucose control (A1c >9%), intensification increased in both groups (intervention, pre 34.8% vs post 62.5%, p=0.002; control, pre 35.7% vs post 61.4%, p=0.008).
conclusionsA wide-reach, low-intensity, web-based interactive multicomponent intervention had no significant incremental effect on medication intensification for control of glucose, blood pressure or lipids for patients with diabetes of physicians practising in the rural Southeastern USA.
trial registrationNCT00403091.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.