Abstract

Background: Long-term metformin therapy is linked with the potential side effect of vitamin B12 deficiency. Although screening is recommended, there is no standardized screening guideline. Vitamin B12 deficiency is frequently unrecognized. An electronic medical record-based alert may lead to more identification and better patient outcomes.

Purpose: The purpose of this project was to determine the impact of focused education on clinician perceptions about the importance of using an electronic medical record-based alert to ensure routine vitamin B12 monitoring in type II diabetic patients prescribed metformin.

Methodology: The organization site for this doctoral project was a single, stand-alone, primary care clinic located in a large metropolitan area in the Midwest of the United States. Clinicians were surveyed before and after participating in a live in-person educational PowerPoint presentation. Participants were given a pre- and post-survey to assess the clinicians own perceived levels of knowledge regarding metformin-induced vitamin B12 deficiency, current ADA recommendations, their current vitamin B12 monitoring practices and their willingness to utilize an EMR-based alert to ensure routine vitamin B12 monitoring.

Implications/Conclusion: Two-tailed t-tests were used to analyze the results. There was a statistical significance in the difference of pre-intervention scores (M = 35.7, SD = 9.3) and post-intervention scores (M = 55.7, SD = 2.9); t = -5.60, p = .001. The effect size, as measured by Cohen's d, was d = 2.90, indicating the intervention had a large effect. Results suggest that the intervention was overall effective. Survey results for this study are indicative of the need to educate clinicians about metformin-induced vitamin B12 deficiency and utilizing the EMR to improve vitamin B12 monitoring procedures.

Ashlee Denny

Author Details

Ashlee Denny, BSN, RN, Family DNP student

Sigma Membership

Non-member

Lead Author Affiliation

Nebraska Methodist College, Omaha, Nebraska, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quasi-Experimental Study, Other

Research Approach

Quantitative Research

Keywords:

Clinical Support Tool, Vitamin B12 Deficienty, Type II Diabetes, Electronic Medical Record Alert

Advisor

Keeling, Tesa

Degree

DNP

Degree Grantor

Nebraska Methodist College

Degree Year

2023

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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Review Type

Faculty Approved: Degree-based Submission

Acquisition

Self-submission

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