Effect of Case-Management Using Home Monitoring on Diabetes and Blood Pressure Outcomes
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Purpose
This is a randomized trial designed to determine if adoption of the chronic care model in conjunction with nurse case management, home telemonitoring, and home HbA1c monitoring can improve glycemic control compared to patients receiving usual case management. We hypothesize that nurse case management, with home telemonitoring of blood sugars and home HbA1c measurement will result in additional improvements in glycemic control compared to isolated nurse case management. Specifically, the telemonitoring group will have an HbA1c 0.5% lower compared to usual nurse case management. Secondary aims include an additional 5 mmHg improvement in systolic blood pressure (among patients with hypertension at the time of enrollment), improved patient satisfaction with treatment, improved medication adherence, reduced incidence of hypoglycemia, and reduced case manager time in the telemonitoring/home HbA1c group compared with usual caes management. The study will enroll 460 diabetic patients with HbA1c values greater than 8.5%, age 75 years or younger, who have a active land-line for telephone communication. Patients will be enrolled and actively case managed for 9 months.
| Condition | Intervention |
|---|---|
|
Diabetes Mellitus |
Behavioral: case management with telemonitoring Behavioral: usual case management |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Effect of Nurse-Based, Protocol-Driven, Case-Management Utilizing Home Telemonitoring and Home HbA1c Measurement on Diabetes and Blood Pressure Outcomes |
- Glycemic control (HbA1c) [ Time Frame: 9 months after enrollment ] [ Designated as safety issue: No ]
- Systolic blood pressure control in patients with elevated blood pressure at baseline [ Time Frame: 9 months after enrollment ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 460 |
| Study Start Date: | June 2009 |
| Study Completion Date: | September 2011 |
| Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Telemonitoring
Case management with home telemonitoring for blood sugar and blood pressure plus home HbA1c measurement
|
Behavioral: case management with telemonitoring
telephone contact with a case manager, home telemonitoring equipment for blood sugar and blood pressure, home HbA1c measurement
|
|
Active Comparator: Usual case management
Case management
|
Behavioral: usual case management
telephone contact with a case manager
|
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Enrolled at Minneapolis VAMC,
- Type 1 or 2 Diabetes,
- HbA1c >8.5%,
- active land-line telephone connection
Exclusion Criteria:
- Age >75 years,
- primary care provider unwilling to have patient enrolled,
- active dialysis,
- resident of assisted living facility,
- research participant in previous diabetes case management study,
- life expectancy <1 year,
- severe mental health condition,
- active substance abuse,
- pregnant or planning on becoming pregnant
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Nacide Ercan-Fang, Principal Investigator, Minneapolis Veterans Affairs Medical Center |
| ClinicalTrials.gov Identifier: | NCT00935441 History of Changes |
| Other Study ID Numbers: | 4127-B |
| Study First Received: | July 8, 2009 |
| Last Updated: | September 14, 2011 |
| Health Authority: | United States: Federal Government United States: Institutional Review Board |
Keywords provided by Minneapolis Veterans Affairs Medical Center:
|
Diabetes mellitus chronic care case management telemedicine |
Additional relevant MeSH terms:
|
Diabetes Mellitus Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |
ClinicalTrials.gov processed this record on May 23, 2013