Reducing Treatment Risk in Older Patients with Diabetes: Comparative Effectiveness of Academic Detailing with and without Pre-Visit Patient Preparation

This pragmatic, randomized clinical trial will compare the effect of primary care physician academic detailing with or without patient pre-visit preparation on insulin de-prescribing rates among older patients with type 2 diabetes at high risk for insulin-related hypoglycemia. We will also examine changes in patient-reported diabetes distress, decisional confidence, and perceived quality of care. In a subset of visits from both study arms, we will also compare the content and quality of patient-provider conversations through analysis of visit audio-recordings.

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