Table 3 Summary of DECIDE intervention changes

DECIDE finder tool

Extension of utilisation to other electronic health records (EHRs) (beyond the Socrates EHR)

A bespoke Finder Function to enable practices utilising other EHRs was developed.

DECIDE CDSS and treatment escalations options

The three domains of suggested intensification options (glycaemic, anti-hypertensive and lipid-lowering medications) were appropriate, and the CDSS was deemed useful to prompt GPs on what evidence-based intensification options were available.

Not applicable.

Non-pharmacological options

Therapeutic intensification actions were deemed not possible in approximately one third of patients, due to complex social reasons.

The DECIDE intervention actions were comprised of three intensification options for glycaemic, BP and lipid-lowering medications. A forth option—providing options of non-pharmacological actions—was added to the intervention. Examples of non-pharmacological actions included referral to a community-based diabetes nurse specialist, asking for more frequent reviews and contacts with the patient or calling the patient in for another review to discuss compliance.

Follow-up of patients

Some patients with poor control were found to have significant care needs, which would require more frequent review.

An increase in the frequency of structured visits for these persons, through individualised reviews, was recommended. Though this is a contractual matter for the GPs concerned in terms of the provision of diabetes care, the DECIDE intervention was modified to enable multiple reviews—not just one review every 6 months.

Introductory educational information on the DECIDE website, in the educational videos and DECIDE practice folder

The educational information in the DECIDE folder was deemed useful.

Some minor additions to this folder, to include the above information, were added.