Peggy Dunbar (Diabetes Care Program of Nova Scotia, Nova Scotia Department of Health and Wellness); Isobel Fleming (Continuing Medical Education, Dalhousie University); Pam McLean-Veysey (Drug Evaluation Unit, Capital Health Pharmacy Department); Michael Allen (Continuing Medical Education, Dalhousie University); Jennifer Isenor (Continuing Pharmacy Education, Dalhousie University)
Summary
In efforts to influence provider practices related to self-monitoring of blood glucose, interagency partnerships as well as innovative tools and methods are needed. Participants will learn how a decision tool provided the “logical next step” in helping to transfer knowledge to practice and the methods used to enhance dissemination and uptake of key messages across provider groups.
Purpose
In 2009, the Canadian Agency for Drugs and Technology in Health published recommendations for the frequency of self-monitoring of blood glucose (SMBG) in persons with diabetes (DM) not taking insulin. Our purpose was to address the recommendations by developing and refining educational materials and methods to reach across provider groups through collaboration of partner agencies in Nova Scotia (NS).
Background
In 2008, the NS Pharmacare Program spent $4 million providing glucose test strips to people with type 2 DM not taking insulin. Simultaneously, a local study demonstrated variations within and between provider groups’ (physicians, pharmacists, and diabetes educators) recommendations regarding the frequency, reasons for, and use of results from SMBG. In today’s health care climate, mixed messaging as well as escalating individual and system costs are powerful motivators for change.
Methods
Building on the evidence, a simple decision tool was developed to help providers determine the need for, and frequency of, SMBG. Using different media and methods to reach and inform our audiences, this tool and two videos are part of 90-minute, case-based, inter-professional workshops. Provincial conferences and academic detailing also provided added reach direct to practice settings.
Results
Health care professionals are receiving consistent evidence-based information. Deployment is ongoing and receptivity to the messages is positive.
Application
Interdisciplinary, interagency collaboration is key to successful deployment and uptake.
Future Directions
An evaluation plan is under development including monitoring prescribing practices through the NS Pharmacare Program and reviewing diabetes educator practices around use of the tool and changes in approach.
Funding Source
NS Dept of Health and Wellness and through the Drug Evaluation Alliance of Nova Scotia and the Diabetes Care Program of Nova Scotia
Declaration
Michael Allen has received an honorarium for serving on the CADTH Expert Review Committee that made the recommendations about self-monitoring. All other authors have nothing to disclose.
