Reminders embedded in PCI reports to optimize discharge diabetes mellitus care (REMIND-DM): Rationale, design, and baseline characteristics - 07/04/25
, Muthiah Vaduganathan, MD MPH a, #Highlights |
• | Innovative intervention: REMIND-DM evaluates a novel reminder-based mechanism leveraging existing clinical pathways and decision support tools, including ACC-endorsed electronic links and QR codes, to facilitate timely initiation of risk-lowering therapies for at-risk patients with diabetes. |
• | Low-cost, Scalable design: The intervention's "low-touch" approach ensures minimal disruption to clinical workflows and can be implemented broadly at a low cost, offering a generalizable solution to improve care delivery. |
• | Addressing challenges: While the intervention relies on site-level quality improvement processes rather than direct EHR integration, a postintervention survey will assess uptake, durability, and acceptability across participating centers, informing future scalability and effectiveness. |
Résumé |
Background |
Despite the robust clinical evidence base supporting their role for high-risk patients with type 2 diabetes (T2DM) and concomitant cardiovascular disease, prescription of sodium-glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RA) remains suboptimal. Clinical encounters occurring in the period post angiography may present a key opportunity to improve implementation in high-risk patients with T2DM.
Methods |
Reminders EMbedded IN PCI Reports to Optimize Discharge Diabetes Mellitus Care (REMIND-DM) is a pragmatic, prospective, cluster randomized quality improvement study in patients with type 2 diabetes undergoing angiography and was run as a quality improvement initiative. Following a 6 month “baseline period”, REMIND-DM randomized 23 participating percutaneous coronary intervention (PCI) sites (caring for 7,045 patients over the study period) within the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) quality improvement collaborative to either usual care or a quality improvement intervention consisting of a templated PCI report “reminder” of medication eligibility linked to a decision support tool. Sites were followed for a 6 month “evaluation period.” The primary outcome is the new prescription of SGLT2 inhibitor or GLP-1RA among eligible patients at discharge after PCI. To examine the effectiveness of the intervention, primary analyses will be conducted using a difference-in-difference design examining changes in new cardioprotective therapy prescription from baseline to the evaluation periods in both arms.
Conclusions |
The REMIND-DM implementation trial has enrolled a large, high-risk population of patients with T2DM and will determine the effectiveness of a low touch QI intervention within BMC2 implemented in the post-PCI period to improve timely prescription of risk lowering therapies in high-risk patients with T2DM.
Le texte complet de cet article est disponible en PDF.Plan
Vol 285
P. 12-20 - juillet 2025 Retour au numéro
Article précédent
- Effects of carvedilol on the prevention of cardiotoxicity induced by anthracyclines: Design and rationale of the CARDIOTOX trial
- Isabela Bispo Santos da Silva Costa, Remo H.M. Furtado, Luciano F. Drager, Pedro Gabriel Melo de Barros e Silva, Marcelo Dantas Tavares de Melo, Paula Araruna, Bruno C. Bacchiega, Sanderson Cauduro, Edilson Walter, Guilherme Loureiro Fialho, Odilson Silvestre, Lucas P. Damiani, Lilian M. Barbosa, Mariane Nascimento Luz, Ana Cecilia Alcantara Silva, Renata Rodrigues de Mattos, Roberta Saretta, Marilia Harumi H.S. Rehder, Ludhmila Abrahao Hajjar, Teresa Lopes-Fernandez, Susan Dent, C. Michael Gibson, Renato D. Lopes, Roberto Kalil Filho, on behalf the CARDIOTOX Investigators
- Oral factor xia inhibitor milvexian after a recent acute coronary syndrome: Rationale and design of the phase 3 (Librexia ACS)
- C. Michael Gibson, M. Cecilia Bahit, Roxana Mehran, Shamir R. Mehta, Rasha Al Lamee, Shinya Goto, Jeffrey I. Weitz, Jay Horrow, Elliot S. Barnathan, Robert A. Harrington, Kenneth W. Mahaffey, Carolyn S.P. Lam, Karen S. Pieper, S. Claiborne Johnston, Graeme J. Hankey, Alexei N. Plotnikov, Danshi Li, Hsiaowei Deng, Philippe Gabriel Steg, Librexia ACS Committees and Investigators.
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?