TOPLINE:

The use of a referral system via electronic health record connected patients with prediabetes to community-based prevention programs, reaching a 21% enrollment rate.

METHODOLOGY:

• Researchers developed an electronic referral system to connect patients with community-based diabetes prevention programs; outcomes were studied over a 1-year period starting in June 2021.
• The study was conducted in the Midwest and included 350 primary care clinicians across 14 clinics.
• Patients had to be at least age 18, have a BMI of 25 (approximately 55 lb) or more, and have a prediabetes diagnosis or a history of gestational diabetes.
• In participating clinics, clinicians located the referral order in the patient’s electronic health record, signed it during visits, and sent it electronically to the National Kidney Foundation of Michigan, Ann Arbor, Michigan; staff then contacted patients to confirm eligibility and help them enroll.
• Prediabetes was defined as an A1c of 5.7%-6.4%, a fasting plasma glucose of 100-125 mg/dL, or a 2-hour oral glucose tolerance test between 140 and 199 mg/dL.

TAKEAWAY:

• Out of 577 referred patients during the evaluation period, 21% enrolled in diabetes prevention programs, which were defined as attending an information session and registering for participation.
• About 30% of targeted primary care clinicians utilized the electronic referral system, with every clinic having at least one referring clinician; 11% of these clinicians accounted for more than half of all referral orders.
• Nearly 73% of referrals met standard eligibility criteria, but this increased to 81% with the broadened CDC, which included a lower BMI cutoff (< 23) for patients who identified as Asian.

IN PRACTICE:

“Our findings demonstrate that an eReferral from an academic health system to community-based diabetes prevention programs is a promising, low-cost, scalable strategy to improve clinician referrals to and patient enrollment in these programs,” the study authors wrote.

SOURCE:

This study was led by Karen Scherr, MD, PhD, of the Duke Center for Childhood Obesity Research and Department of Family Medicine and Community Health at Duke University in Durham, North Carolina. It was published online in Annals of Family Medicine.

LIMITATIONS:

The intervention was only implemented at a single health system setting.

DISCLOSURES:

One study author reported receiving consulting fees from the National Kidney Foundation of Michigan and serving on the foundation’s scientific advisory board. No other disclosures were reported.