@article {Gomes35, author = {Tara Gomes and David N. Juurlink and Baiju R. Shah and J. Michael Paterson and Muhammad M. Mamdani}, title = {Blood glucose test strips: options to reduce usage}, volume = {182}, number = {1}, pages = {35--38}, year = {2010}, doi = {10.1503/cmaj.091017}, publisher = {CMAJ}, abstract = {Background: Recent evidence suggests that, despite widespread use, self-monitoring of blood glucose levels has little clinical benefit in many patients with diabetes. The impact of more focused public-payer policies for the use of blood glucose test strips may be substantial. Methods: We conducted a cross-sectional analysis of annual prescription claims for test strips between 1997 and 2008 for patients in Ontario aged 65 and older with diabetes. Patients were stratified into 1 of 4 hierarchical groups according to the most intensive glucose-lowering treatment received during each calendar year. Test strip use was calculated annually for each group over the study period, and the effects of 5 hypothetical policy scenarios of more selective test strip use were assessed. Results: Test strip use increased by almost 250\% from 1997 to 2008, with 52.6\% (n = 263 513) of included patients receiving a prescription during 2008. Almost half of these patients were at low risk for drug-induced hypoglycemia. In 2008, over 117 million test strips were dispensed in Ontario; however, more focused policy scenarios could have reduced this number by between 9.5 million and 74.5 million test strips. Interpretation: Many people who self-monitor their blood glucose are at relatively low risk for drug-induced hypoglycemia. The economic benefits associated with more selective testing could be redirected to more effective interventions for patients with diabetes.}, issn = {0820-3946}, URL = {https://www.cmaj.ca/content/182/1/35}, eprint = {https://www.cmaj.ca/content/182/1/35.full.pdf}, journal = {CMAJ} }