EMR prompts in primary care to help prevent prediabetes from becoming diabetes
Preventing Diabetes: Impact of an EMR-Based Intervention for Enhanced Pre-Diabetes Management in Primary Care
This project will test whether electronic medical record prompts for doctors in primary care help adults with prediabetes avoid developing diabetes.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 6000 (estimated) |
| Ages | 21 Years to 59 Years |
| Sex | All |
| Sponsor | National University Polyclinics, Singapore Academic / other |
| Locations | 1 site (Singapore) |
| Trial ID | NCT07252700 on ClinicalTrials.gov |
What this trial studies
This is a two-year cluster-randomized trial across eight National University Polyclinics in Singapore comparing clinics that receive EMR-based clinical decision-support prompts to clinics that do not. All clinicians receive standardized guideline training and patient education materials, while the EMR prompts suggest tests, referrals, follow-up timing, and consideration of metformin when appropriate. The primary analyses use an EMR-based cohort of adults 21–59 with prediabetes and a nested survey cohort of English-speaking patients aged 40–59 to capture patient-reported behaviors. Outcomes include rates of recommended follow-up care (HbA1c testing, referrals, medication starts) and whether fewer patients progress to diabetes within six months.
Who should consider this trial
Good fit: Adults aged 21–59 with prediabetes who receive care at the participating National University Polyclinics (with a survey subgroup of English-speaking patients aged 40–59 able to consent).
Not a fit: People with an existing diabetes diagnosis, pregnant patients, those with severe liver or kidney disease, those with cognitive impairment, or those who do not attend the participating clinics are unlikely to benefit from this intervention.
Why it matters
Potential benefit: If successful, the intervention could increase timely follow-up and appropriate treatment and reduce short-term progression from prediabetes to diabetes.
How similar studies have performed: Electronic decision-support tools in primary care have improved guideline adherence and screening in other conditions, but randomized evidence showing reduced progression from prediabetes to diabetes is limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria for study population (EMR based analytic cohort): * All adults aged 21 to 59 years with prediabetes who attend any of the eight participating polyclinics during the study period will be included in the EMR-based analytic cohort. * Prediabetes is defined as impaired fasting glucose or impaired glucose tolerance according to standard clinical criteria, with either diagnosis documented in the EMR problem list or visit diagnosis. * Individuals with a prior diagnosis of diabetes will be excluded. Inclusion Criteria for patient surveys: * Adults aged 40-59 years * Diagnosed with prediabetes (impaired fasting glucose or impaired glucose tolerance) * Receiving routine follow-up care at NUP polyclinics * Able to provide written informed consent * Able to complete questionnaires in English Exclusion criteria for patient surveys: * Prior diagnosis of diabetes mellitus or gestational diabetes * Severe acute or chronic liver or kidney disease * Pregnancy * Cognitive impairment * Inability to communicate in English Inclusion Criteria for clinician surveys: * All clinicians that consult patients in National University Polyclinics * No exclusion criteria specified for clinicians
Where this trial is running
Singapore
- National University Polyclinics, Singapore — Singapore, Singapore (Recruiting)
Study contacts
- Study coordinator: Lynette ML Goh, BNutrDiet
- Email: lynette_ml_goh@nuhs.edu.sg
- Phone: 6598235619
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.