Category: Federal Forum Posters
Purpose: Current clinical guidelines have limited recommendations regarding the optimal frequency for self-monitoring of blood glucose in patients with non-insulin dependent type 2 diabetes (T2DM). Without clear recommendations, the Veterans Health Administration (VHA) has developed guidance for prescribing to minimize unnecessary use of test strips without adversely affecting the care of the Veteran. VHA guidance was updated in 2018 which is more strict than previous guidance; however, it has not yet been implemented. The purpose of this evaluation is to retrospectively determine if the use of blood glucose test strips in Veterans with non-insulin dependent T2DM follows the current VHA guidance.
Methods: Veterans prescribed blood glucose test strips in the last twelve months will be identified. Veterans receiving antidiabetic agents other than metformin will be excluded, as well as those with a diagnosis of diabetes within the last three months. The following data will be collected from the Veterans Affairs Health Care System (VAHCS) electronic medical record: baseline demographics, including gender, age, ethnicity, and BMI; quantity of test strips received; antidiabetic medication regimen; HgbA1c; number of hypoglycemic episodes; oral and parenteral corticosteroids received in the last twelve months; time since diagnosis of T2DM; and prescribing service. Prior to analysis, all patient identifiers will be removed and data will be stored confidentially. The data collected will be analyzed to determine adherence to the current VHA test strip guidance. The data will also be used to estimate test strip cost savings once the new guidance is implemented. Outcomes including average HgbA1c, reason for receiving additional test strips under new guidance, and prescribing service, will be analyzed using descriptive statistics. This medication use evaluation protocol was approved by the facility’s Investigational Review Board (IRB) and Pharmacy and Therapeutics Committee.
Results: not applicable
Conclusion: not applicable
Elisabeth Schulz– PGY1 Resident, Salisbury Veterans Affairs Health Care System, Salisbury, NC