The following is the summary of “Coordinating Cardiology clinics randomized trial of interventions to improve outcomes (COORDINATE) – Diabetes: rationale and design” published in the February 2023 issue of Heart Journal by Nelson, et al.
Individuals who suffer from type 2 diabetes mellitus (T2DM) with atherosclerotic cardiovascular disease have access to a number of drugs that have been shown to lower the occurrence of cardiovascular events; nevertheless, these medications are significantly underutilized in clinical practice. These gaps in care are caused by a number of factors, including barriers at the clinician, patient, and system levels; nonetheless, there is a dearth of high-quality, rigorous research investigating the role of interventions to boost use.
The COORDINATE-Diabetes trial randomly assigned 42 cardiology clinics located across the United States to either a multimodal, site-specific intervention focused on evidence-based care for patients with type 2 diabetes or to the standard of care. In addition to patient-facing technologies, the multimodal solution included the construction of an interprofessional treatment route for each clinic, tools for auditing and providing feedback, and educational outreach. The primary outcome will be the proportion of individuals with type 2 diabetes who have prescribed three key classes of evidence-based medications.
These medications include a high-intensity statin, an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker, and either a sodium/glucose cotransporter-2 inhibitor (SGLT-2i) inhibitor or glucagon-like peptide 1 receptor agonist (GLP-1RA). This proportion will be evaluated at least 6 months after participant COORDINATE-Diabetes is an initiative to identify ways that will improve the acceptance and implementation of evidence-based therapy.