Chronic cardiometabolic disease vignettes
nonadherence, DM/HTN
DISEASE PROGRESSION, DISEASE
We constructed nine CPV vignettes on a 3 × 3 matrix with three patient case types and three variants (see Supplement 2). The case types included patients with Afib, HF, or DM/HTN. The three variants included patients who were not at their therapeutic goal because of: medication nonadherence but no DDI (NA); because of a DDI but adherent to their medications (DDI); and disease progression who were both adherent to their medications and had no DDI (AND). For the AND patients, a diagnosis of disease progression was made with either explicitly diagnosing worsening disease, selecting a new medication, increasing the dose of medication, or referring to a specialist. To avoid ordering effects, every participant cared for three CPV patients, one randomly assigned from each case type and from each variant type. At the end of the two rounds, each participant completed a total of six patient cases, three patients per round, one from each case type and case variant, with no provider seeing the same patient more than once.