A quality initiative implementing CDC STAT toolkit to prevent prediabetes progression in primary care
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Background: Untreated prediabetes (pre-DM) has the potential to progress to type 2 diabetes (T2D). Among the 33.9% of U.S. adults living with pre-DM, 70% are unaware of their diagnosis. The purpose of this DNP project was to design an evidence-based quality improvement (QI) project to improve provider adoption of the STAT (Screen/Test/Act Today) toolkit to prevent progression of pre-DM to T2D. This detailed toolkit was developed to identify, screen, and refer at-risk patients to community diabetes prevention programs (DPPs). Design and methods: A quality improvement initiative to determine if the use of the CDC pre-DM STAT toolkit improved provider adoption of patient screening, testing, management and referral to a community DPP with the goal of preventing progression of pre-DM to T2D. The EHR triggered the pre-DM risk assessment at annual visits, PCP reviewed scores with patients with moderate to high risk, BMI and A1C are measured and patients referred to community DPP. Pretest and posttest were used to analyze patient knowledge pre and post intervention, while paired t-test measured changes in AIC and BMI. Findings: Sample included 2 females and 5 males, over 21 and less than 75 years old. During the 3-month implementation, screening and referral rates doubled with 75% of participants showing an average 3% reduction in A1C from baseline to 3 months. In this primary care setting, the CDC pre-DM STAT toolkit provided an efficient, detailed clinical reference to increase patient screening for pre-DM, improving referral to DPPs. Due to COVID-19 barriers, reduced progression of pre-DM to T2D could not be measured in this QI project’s limited timeframe.