Evidence map›Paper›PMID 39986337›Full record

ArticleAmerican heart journal2025

Encouraging the prescribing of SGLT2i and GLP-1RA medications to reduce cardiovascular and renal risk in patients with type 2 diabetes: Rationale and design of a randomized controlled trial.

Nancy Haff, Daniel M Horn, Gauri Bhatkhande, Meekang Sung, Caitlin Colling, Wendy Wood, Ted Robertson, Daniel Gaposchkin, Leigh Simmons, Judy Yang and 5 more

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in American heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05463705 (Addressing Diffusion of Responsibility and Prescribing Burden to Improve Use of Diabetes Medications), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT05463705 nacompletednot on this map

Addressing Diffusion of Responsibility and Prescribing Burden to Improve Use of Diabetes Medications

TypeinterventionalSponsorBrigham and Women's HospitalRan2023 to 2024Enrolled1,580ConditionsDiabetes, SGLT-2i and GLP-1RA Therapies, Diffusion of Responsibility, Prescribing BurdenArmsIntervention to address diffusion of responsibility, Intervention to address diffusion of responsibility + simplification of prescribing
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Nancy HaffCenter for Healthcare Delivery Sciences, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: nhaff@mgb.org.
Daniel M HornHarvard Medical School, Boston, MA; Department of Medicine, Massachusetts General Hospital, Boston, MA; Medical Director of Devoted Health, Waltham, MA.
Gauri BhatkhandeCenter for Healthcare Delivery Sciences, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Meekang SungCenter for Healthcare Delivery Sciences, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Caitlin CollingHarvard Medical School, Boston, MA; Department of Medicine, Massachusetts General Hospital, Boston, MA.
Wendy WoodDepartment of Psychology & Marshall School of Business, University of Southern California, Los Angeles, CA.
Ted Robertsonideas42, New York, NY; Executive Director of the Center for Healthcare Marketplace Innovation at the University of California, Berkeley, CA.
Daniel GaposchkinHarvard Medical School, Boston, MA; Department of Medicine, Massachusetts General Hospital, Boston, MA.
Leigh SimmonsHarvard Medical School, Boston, MA; Department of Medicine, Massachusetts General Hospital, Boston, MA.
Judy YangHarvard Medical School, Boston, MA; Department of Medicine, Massachusetts General Hospital, Boston, MA.
James YehHarvard Medical School, Boston, MA; Department of Medicine, Massachusetts General Hospital, Boston, MA.
Katherine L CrumCenter for Healthcare Delivery Sciences, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Kaitlin E HankenCenter for Healthcare Delivery Sciences, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Julie C LauffenburgerCenter for Healthcare Delivery Sciences, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Niteesh K ChoudhryCenter for Healthcare Delivery Sciences, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.

Funding

The Roybal Center for Therapeutic Optimization using Behavioral ScienceP30AG064199 · BRIGHAM AND WOMEN'S HOSPITAL · 2025 to 2025
$1.2M
Development of an implementation-ready antihypertensive self-titration intervention to improve US blood pressure controlK23HL161480 · BRIGHAM AND WOMEN'S HOSPITAL · 2025 to 2025
$135k
NHLBI NIH HHS K23 HL161480NIA NIH HHS P30 AG064199
6 · The paper itself

Abstract

backgroundSodium-glucose cotransporter-2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonist (GLP-1RA) medications reduce the risk of cardiovascular and renal complications among patients with type 2 diabetes but are underutilized. There are numerous barriers to prescribing including insurance coverage, medication availability, comfort with prescribing, and diffusion of responsibility of prescribing across specialists. Methods are needed to support prescribing in primary care.

methodsThis was a pragmatic, randomized controlled trial testing interventions to increase appropriate SGLT2i and GLP-1RA prescribing. Primary care providers (PCPs) were randomized to 1 of 3 arms: (1) peer champion support (2) peer champion support and information on insurance coverage, or (3) usual care (no intervention). PCPs in both intervention arms received a welcome email and electronic health record (EHR) messages before visits with patients who had sub-optimally controlled diabetes and an indication for 1 of these medications. In the peer champion support only arm the EHR messages included prescribing tips. In the arm that provided peer champion support and information on insurance coverage, EHR messages contained information on medications in each class that would be most affordable for the patient based on their insurance coverage and offered support for prior authorizations if needed. The primary outcome was prescriptions for an SGLT2i or GLP-1RA medication, beginning 3 days before the targeted visit and continuing through 28 days, in each intervention arm compared to control.

results191 primary care providers were included in the study. 1,389 patients had at least 1 visit scheduled with their PCP during the 6-month intervention period; of these 1,079 patients attended at least 1 of these visits and will be included in the primary outcome analysis. 66 providers (484 patients) received the peer champion intervention alone, 63 providers (446 patients) received the peer champion intervention and information on insurance coverage, and 62 providers (459 patients) received usual care. On average, patients were 66 years old, 46% were female, 61% were white, and 16% were Hispanic. There were small differences between groups with regards to patient sex, race, ethnicity, partner status, and percent with Medicare insurance.

conclusionsThese medication classes have the potential to reduce cardiovascular and kidney disease among patients with type 2 diabetes. This study tests interventions to support prescribing of these medications in primary care. CLINICAL TRIAL: Clinicaltrials.gov. Unique identifier: (NCT, Registered: NCT05463705).

Indexed as

Cardiovascular DiseasesDiabetes Mellitus, Type 2Diabetic NephropathiesGlucagon-Like Peptide-1 Receptor AgonistsPractice Patterns, Physicians'Sodium-Glucose Transporter 2 InhibitorsAgedFemaleHumansMaleMiddle AgedPragmatic Clinical Trials as TopicPrimary Health CareRandomized Controlled Trials as TopicGlucagon-Like Peptide-1 Receptor AgonistsSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID39986337
PMCPMC11981828

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

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 Socratic graph.