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How good are GPs at adhering to a pragmatic trial protocol in primary care? Results from the ADDITION-Cambridge cluster-randomised pragmatic trial

Overview of attention for article published in BMJ Open, June 2018
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  • Above-average Attention Score compared to outputs of the same age (59th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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6 tweeters
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1 Facebook page

Citations

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1 Dimensions

Readers on

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27 Mendeley
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Title
How good are GPs at adhering to a pragmatic trial protocol in primary care? Results from the ADDITION-Cambridge cluster-randomised pragmatic trial
Published in
BMJ Open, June 2018
DOI 10.1136/bmjopen-2016-015295
Pubmed ID
Authors

Michael Laxy, Edward C F Wilson, Clare E Boothby, Simon J Griffin

Abstract

To assess the fidelity of general practitioners' (GPs) adherence to a long-term pragmatic trial protocol. Retrospective analyses of electronic primary care records of participants in the pragmatic cluster-randomised ADDITION (Anglo-Danish-Dutch Study of Intensive Treatment In People with Screen Detected Diabetes in Primary Care)-Cambridge trial, comparing intensive multifactorial treatment (IT) versus routine care (RC). Data were collected from the date of diagnosis until December 2010. Primary care surgeries in the East of England. A subsample (n=189, RC arm: n=99, IT arm: n=90) of patients from the ADDITION-Cambridge cohort (867 patients), consisting of patients 40-69 years old with screen-detected diabetes mellitus. In the RC arm treatment was delivered according to concurrent treatment guidelines. Surgeries in the IT arm received funding for additional contacts between GPs/nurses and patients, and GPs were advised to follow more intensive treatment algorithms for the management of glucose, lipids and blood pressure and aspirin therapy than in the RC arm. The number of annual contacts between patients and GPs/nurses, the proportion of patients receiving prescriptions for cardiometabolic medication in years 1-5 after diabetes diagnosis and the adherence to prescription algorithms. The difference in the number of annual GP contacts (β=0.65) and nurse contacts (β=-0.15) between the study arms was small and insignificant. Patients in the IT arm were more likely to receive glucose-lowering (OR=3.27), ACE-inhibiting (OR=2.03) and lipid-lowering drugs (OR=2.42, all p values <0.01) than patients in the RC arm. The prescription adherence varied between medication classes, but improved in both trial arms over the 5-year follow-up. The adherence of GPs to different aspects of the trial protocol was mixed. Background changes in healthcare policy need to be considered as they have the potential to dilute differences in treatment intensity and hence incremental effects. ISRCTN86769081.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 27 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 7 26%
Researcher 4 15%
Student > Master 4 15%
Student > Doctoral Student 3 11%
Unspecified 2 7%
Other 4 15%
Unknown 3 11%
Readers by discipline Count As %
Medicine and Dentistry 7 26%
Nursing and Health Professions 4 15%
Biochemistry, Genetics and Molecular Biology 2 7%
Pharmacology, Toxicology and Pharmaceutical Science 2 7%
Social Sciences 2 7%
Other 4 15%
Unknown 6 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 July 2020.
All research outputs
#5,058,494
of 15,999,775 outputs
Outputs from BMJ Open
#8,080
of 14,684 outputs
Outputs of similar age
#107,300
of 278,565 outputs
Outputs of similar age from BMJ Open
#288
of 588 outputs
Altmetric has tracked 15,999,775 research outputs across all sources so far. This one is in the 48th percentile – i.e., 48% of other outputs scored the same or lower than it.
So far Altmetric has tracked 14,684 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 19.3. This one is in the 43rd percentile – i.e., 43% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 278,565 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 59% of its contemporaries.
We're also able to compare this research output to 588 others from the same source and published within six weeks on either side of this one. This one is in the 49th percentile – i.e., 49% of its contemporaries scored the same or lower than it.