Shah 2010.

Trial name or title	Evaluation of a toolkit to improve cardiovascular disease screening and treatment for people with type 2 diabetes: protocol for a cluster‐randomized pragmatic trial
Methods	Study design: C‐RCT Unit of allocation: practice Stratification by: health region Type of comparison:  PEM only vs. nothing group A: toolkit received in spring 2010 group B: toolkit received in Spring 2009
Participants	Physicians Clinical speciality: general practice/family medicine; Level of training: not clear
Interventions	The cardiovascular disease toolkit was packaged in a brightly coloured box with CDA branding. The contents included an introductory letter from the Chair of the practice guidelines' Dissemination and Implementation Committee; an 8‐page summary of selected sections of the practice guidelines targeted towards primary care physicians; a 4‐page synopsis of the key guideline elements pertaining to cardiovascular disease risk; a small double‐sided laminated card with a simplified algorithm for cardiovascular risk assessment, vascular protection strategies and screening for cardiovascular disease; and a pad of tear‐off sheets for patients with a cardiovascular risk self‐assessment tool and a list of recommended risk reduction strategies. In the intervention group, the Toolkit was mailed with the Spring 2009 edition of Canadian Diabetes, a newsletter from the CDA which provides practical information on diagnosis and treatment issues associated with diabetes that is sent quarterly to all primary care physicians in Canada. The content of this edition of the newsletter did not pertain to cardiovascular risk screening or treatment. Both the Toolkit and Canadian Diabetes were packaged together in a large mailing envelope. The control group received Canadian Diabetes alone in its usual shrink wrap packaging, and will receive the Toolkit with the Spring 2010 edition of the newsletter
Outcomes	The primary outcome will be that the patient is receiving a statin. Secondary outcomes will include 1) the receipt of an angiotensin converting enzyme inhibitor or angiotensin receptor blocker, 2) various intermediate measures (A1c, BP, LDL‐cholesterol, total‐/HDL‐cholesterol ratio, body mass index, and waist circumference), and 3) clinical inertia (the failure to change therapy in response to an abnormal A1c, BP, or cholesterol reading)
Starting date	Spring 2010
Contact information	Baiju Shah University of Toronto, Toronto, Ontario, Canada Email: baiju.shah@ices.on.ca
Notes	‐