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IMPLEMENTING CGM IN PRIMARY CARE PRACTICES VIA THE AMERICAN ACADEMY OF FAMILY PHYSICIANS TIPS CGM MODULE WITH AND WITHOUT PRACTICE FACILITATION: A RANDOMIZED TRIAL
Abstract
Background and Aims
Primary care performs diabetes management for approximately 50% of adult patients with type 1 diabetes and 90% of those with type 2 diabetes in the United States, yet CGM uptake is significantly lower in primary care than in endocrinology despite known glycemic and quality-of-life benefits. This project aims to increase CGM uptake in primary care practices in Colorado, with a randomized trial comparing two CGM implementation strategies. The investigators, in conjunction with the American Academy of Family Physicians (AAFP), developed a Transformation in Practice Series (TIPSTM) CGM implementation package for primary care practices. Practice facilitation is a strategy shown to enhance implementation efforts. This study will compare CGM implementation using AAFP TIPSTM CGM with and without additional practice facilitation to assist in implementation.
Methods
40 Colorado primary care practices will agree to use the AAFP TIPSTM CGM package to implement CGM and will be randomized to receive (a) no additional support resources or (b) six professional practice facilitation sessions for CGM implementation.
Results
Primary outcome: CGM prescriptions initiated. Secondary outcomes: changes in HbA1c, CGM glycemic metrics, diabetes distress, practice satisfaction, and patient satisfaction. Economic analysis will also be conducted.
Conclusions
We anticipate that AAFP TIPSTM CGM implementation will increase primary care practice CGM initiation, with practice facilitation adding incremental benefit. Relative costs vs. revenue will be determined and compared for the two groups.