Effect of Best Practice Advisory on Glucagon Prescribing in Patients With Diabetes at a Federally Qualified Health Center

OBJECTIVE Glucagon is recommended for patients using insulin or at high risk for hypoglycemia, yet prescribing rates remain low. This study assessed the impact of a best practice advisory (BPA) in the electronic health record on glucagon prescribing at a federally qualified health center. RESEARCH DESIGN AND METHODS A BPA was triggered when providers ordered bolus or U-500 insulin, prompting clinician consideration of glucagon. Six months of data were analyzed for demographics, medications, and BPA acceptance. RESULTS Among 370 alerts for 301 patients, the glucagon prescribing rate directly from the BPA was 32.7%, with 121 new glucagon orders, though 161 patients (54.2%) received glucagon by the end of data analysis. CONCLUSIONS BPAs at the point of care facilitated glucagon prescribing. Expanding implementation and refining the alert’s timing could enhance provider engagement and clinical outcomes. Future research regarding medication fills and patient use to fully assess hypoglycemia prevention is needed.