Acceptability and Feasibility of a Primary Care Hypoglycemia Prevention Program: A Pilot Study.

objectiveHypoglycemia, a major cause of morbidity for people with diabetes, is underrecognized in primary care, leading to underuse of risk mitigation strategies. This study reports the development and acceptability/feasibility testing of the Hypoglycemia Prevention Program (HPP), an electronic health record-integrated toolkit for primary care. RESEARCH DESIGN AND

methodsThe HPP was developed through stakeholder engagement and included a pre-visit hypoglycemia history survey, primary care provider (PCP) hypoglycemia toolkit, and patient self-management handout. The HPP pilot study was a pre-post clinical trial at one primary care practice. Participants were adults with diabetes treated with insulin or sulfonylureas, their PCPs, and clinic staff. The primary outcome was acceptability; exploratory outcomes included pre- to postintervention change in PCP hypoglycemia prevention actions, self-reported hypoglycemia, and optional blinded 10-day continuous glucose monitoring (CGM).

resultsThe intervention was completed by 31 of 35 enrolled patients with diabetes (89%) for whom it triggered frequent hypoglycemia alerts. The intervention was rated acceptable or completely acceptable by 87% of patients and 100% of participating PCPs (

conclusionsA hypoglycemia prevention program designed for primary care is feasible to implement and acceptable to clinical and patient stakeholders, with evidence of improved hypoglycemia prevention efforts. Further efficacy evaluation is needed.