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Reducing Clinical Inertia in Obesity Management of Diabetes in Primary Care: Cluster-Randomized Trial

Award Number: R01DK128281
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 05/01/2021
PERIOD OF PERFORMANCE END DATE: 04/30/2026

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Reducing Clinical Inertia in Obesity Management of Diabetes in Primary Care: Cluster-Randomized Trial - Project Summary Obesity has been steadily increasing in prevalence and now affects more than 4 in 10 U.S. adults, leading to many adverse health outcomes including myocardial infarction, stroke, type 2 diabetes (T2DM), hypertension, sleep apnea, arthritis, and others. Effective surgical, pharmaceutical, and behavioral treatments for obesity are available, and the evidence to support the broad use of these treatments for obesity is very well established. However, active management of obesity defined as prescribing or referring adults with obesity for lifestyle, pharmaceutical, or surgical treatment of obesity, is greatly underused. Major underlying reasons for underutilization of effective obesity treatments include: (a) both patients and primary care clinicians (PCCs) frequently underestimate the effectiveness and potential benefits of obesity treatments; and (b) both patients and clinicians typically lack access to evidence-based, patient-specific estimates of the potential benefits and risks of appropriate patient-specific obesity treatment options. To address this problem, we integrate externally validated prediction equations that estimate benefits and risk of various obesity treatment options in adults with T2DM into a widely-used and successful clinical decision support system in order to deliver appropriate patient-specific obesity treatment suggestions at the point of care. We implement a scalable, web-based point-of-care decision-support intervention in a randomized trial in 40 primary care clinics with 15,814 eligible patients, and assess intervention impact on the following primary outcomes: (a) appropriate referral of eligible patients for evaluation for metabolic bariatric surgery (MBS); (b) appropriate initiation of FDA-approved medications for weight loss; (c) weight trajectories; and (d) patient- reported conversations with their PCC about weight loss and intentions to engage in weight loss. In addition, we collect and analyze clinician-reported and patient-reported data to identify factors that may impede or facilitate broad dissemination of this intervention strategy to other care delivery settings. This innovative project will (a) provide state-of-the-art scientific evidence on obesity treatment to large numbers of obese American adults with T2DM and their PCCs at the point of care; (b) help PCCs identify appropriate patient-specific obesity treatment options; (c) implement in primary care a web-based EHR-linked obesity treatment clinical decision support model that uses state-of-the-art HIT standards, is broadly scalable, easy to update as evidence changes, and optimized for clear communication of information to patients and PCCs; and (d) improve the clinical return on ongoing massive private and public investments in outpatient health information systems.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $630,033 )
2025	2025	HEALTHPARTNERS INSTITUTE	8170 33RD AVE S	MINNEAPOLIS	MN	55425	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	6/3/2025	NON-COMPETING CONTINUATION	$630,033
														Subtotal = $630,033

Issue Date FY: 2024 ( Subtotal = $615,063 )
2024	2024	HEALTHPARTNERS INSTITUTE	8170 33RD AVE S	MINNEAPOLIS	MN	55425	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	5/20/2024	NON-COMPETING CONTINUATION	$615,063
														Subtotal = $615,063

Issue Date FY: 2023 ( Subtotal = $773,172 )
2023	2023	HEALTHPARTNERS INSTITUTE	8170 33RD AVE S	MINNEAPOLIS	MN	55425	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	3	5/8/2023	SUPPLEMENT FOR EXPANSION	$116,920
2023	2023	HEALTHPARTNERS INSTITUTE	8170 33RD AVE S	MINNEAPOLIS	MN	55425	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	3	5/5/2023	NON-COMPETING CONTINUATION	$656,252
2023	2022	HEALTHPARTNERS INSTITUTE	8170 33RD AVE S	MINNEAPOLIS	MN	55425	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	2/3/2023	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $773,172

Issue Date FY: 2022 ( Subtotal = $747,325 )
2022	2022	HEALTHPARTNERS INSTITUTE	8170 33RD AVE S	MINNEAPOLIS	MN	55425	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	2	9/12/2022	SUPPLEMENT FOR EXPANSION	$77,946
2022	2022	HEALTHPARTNERS INSTITUTE	8170 33RD AVE S	MINNEAPOLIS	MN	55425	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	5/5/2022	NON-COMPETING CONTINUATION	$669,379
														Subtotal = $747,325

Issue Date FY: 2021 ( Subtotal = $680,108 )
2021	2021	HEALTHPARTNERS INSTITUTE	3311 E OLD SHAKOPEE RD	BLOOMINGTON	MN	55425	HENNEPIN	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	4/19/2021	NEW	$680,108
														Subtotal = $680,108

Grand Total All Awards = $3,445,701

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Reducing Clinical Inertia in Obesity Management of Diabetes in Primary Care: Cluster-Randomized Trial

Award Number: R01DK128281

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 05/01/2021

PERIOD OF PERFORMANCE END DATE: 04/30/2026

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