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The following is a summary of “Re-Think the Strip: de-implementing a low value practice in primary care,” published in the April 2025 issue of BMC Primary Care by Donahue et al. 

Self-monitoring of blood glucose (SMBG) offers no benefit for most patients with non-insulin treated type 2 diabetes (T2DM). Eliminating its use can improve primary care efficiency. 

Researchers conducted a retrospective study on Re-Think the Strip (RTS), a multi-component approach to eliminating SMBG in patients with non-insulin-treated T2DM, assessing its impact in primary care. 

They used a pre-post design to evaluate RTS in 20 clinics, comparing it with 34 clinics in one health system. De-implementation strategies were applied for 12 months, with an 18-month follow-up. 

The results showed a decrease in the odds of receiving diabetes testing supplies between baseline and 12 months in both groups (OR 0.96, 95% CI 0.94, 0.98). However, prescribing did not differ significantly between groups. Sensitivity analyses showed a small intervention effect for newly diagnosed or newly assigned patients (OR 0.97, 95% CI 0.95, 1.00). 

Investigators found de-implementation strategies feasible in primary care, but SMBG prescriptions declined in both groups. Newly diagnosed or new patients were more receptive, while COVID-19 and baseline prescribing rates may have limited RTS effectiveness. 

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-025-02781-6