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Use of Online Personalized Health Record System to Promote Self-Management of Diabetes (EMPOWER-D)

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ClinicalTrials.gov Identifier: NCT00542204
Recruitment Status : Completed
First Posted : October 10, 2007
Last Update Posted : April 28, 2015
Agency for Healthcare Research and Quality (AHRQ)
Sutter Health
Information provided by (Responsible Party):
Paul Tang, Palo Alto Medical Foundation

Brief Summary:
Diabetes is a major, growing, and costly chronic disease in the U.S., and implementation of recommended diabetes care remains poor, not merely suboptimal, and varied for a sizable proportion of Americans with diabetes. To further reduce the treatment and adherence gaps in diabetes care, the researchers propose to evaluate a Customized, Continuous Care Management (CCCM) program that actively supports a partnership between the patient and his/her multidisciplinary care management (CM) team using an online disease management (ODM) system, which is integrated with a comprehensive electronic health record (EHR) system that includes a personal health record and secure patient-clinician messaging capabilities. The CCCM program builds upon CM strategies proven effective in past studies and creates an ODM system that is built upon and fully integrated with a leading, commercially available EHR product - providing a blueprint for instituting customized, continuous care management for many different chronic conditions in a range of ambulatory care settings.

Condition or disease Intervention/treatment
Diabetes Mellitus Behavioral: Online disease management

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 415 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Investigator)
Primary Purpose: Health Services Research
Official Title: Patient-Centered Online Disease Management Using a Personal Health Record System
Study Start Date : March 2008
Primary Completion Date : March 2011
Study Completion Date : August 2011

Arm Intervention/treatment
Experimental: Online disease management
The PAMFOnline-mediated Personalized Health Care Program, which couples a multidisciplinary diabetes care management team with an EHR-integrated Online Disease Management (ODM) system.
Behavioral: Online disease management
The Personalized Health Care Program couples a multidisciplinary care management team with an EHR-integrated Online Disease Management (ODM) system.
Other Name: EMPOWER-D
No Intervention: Usual care
Usual medical care. No access to the PHCP electronic system and self-management tools supporting this care management.

Primary Outcome Measures :
  1. Hemoglobin A1C [ Time Frame: Baseline, 6 months and 12 months ]

Secondary Outcome Measures :
  1. Self-management practices(e.g., medication adherence, home monitoring of glucose and BP, diet, and exercise) [ Time Frame: Baseline, 6 months and 12 months ]
  2. Processes of care (e.g., frequency of lab testing) [ Time Frame: Baseline, 6 months and 12 months ]
  3. Cardiovascular risk (e.g., blood pressure and lipids) [ Time Frame: Baseline, 6 months and 12 months ]
  4. Patient experience and satisfaction (e.g., relevant CAHPS measures) [ Time Frame: Baseline and 12 months ]
  5. Patient psychosocial well-being (e.g., diabetes-related emotional distress) [ Time Frame: Baseline, 6 months and 12 months ]

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • >= 18 years of age
  • Have a designated Palo Alto Medical Foundation Primary Care Provider (PCP)
  • Seen in primary or specialty care at the Palo Alto Division at least once in the preceding 24 months
  • Diagnosis of diabetes
  • Baseline A1C >= 7.5%

Exclusion Criteria:

  • Initial diagnosis of diabetes within the last 12 months
  • Diagnosis of Type 1 diabetes
  • Inability to speak and read in English
  • Lack of regular access to a computer with Internet and email capabilities
  • Unwilling to perform any self-monitoring at home, including blood glucose and blood pressure%
  • Pregnant, planning to become pregnant, or lactating
  • Currently enrolled in a care management program at Palo Alto Medical Foundation or elsewhere
  • PCP determination that the study is inappropriate or unsafe for the patient
  • Investigator discretion for clinical safety or protocol adherence reasons

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00542204

United States, California
PAMF Palo Alto Health Care Division
Fremont, California, United States, 94538
PAMF Palo Alto Health Care Division
Los Altos, California, United States, 94022
PAMF Camino Region
Mountain View, California, United States, 94040
PAMF Palo Alto Health Care Division
Palo Alto, California, United States, 94301
PAMF Palo Alto Health Care Division
Redwood City, California, United States, 94063
PAMF Santa Cruz Medical Clinic
Santa Cruz, California, United States, 95062
Sponsors and Collaborators
Palo Alto Medical Foundation
Agency for Healthcare Research and Quality (AHRQ)
Sutter Health
Principal Investigator: Paul Tang, M.D. Palo Alto Medical Foundation

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Paul Tang, Vice President, Palo Alto Medical Foundation
ClinicalTrials.gov Identifier: NCT00542204     History of Changes
Other Study ID Numbers: 1R18HS017179-01 ( U.S. AHRQ Grant/Contract )
First Posted: October 10, 2007    Key Record Dates
Last Update Posted: April 28, 2015
Last Verified: April 2015

Keywords provided by Paul Tang, Palo Alto Medical Foundation:
Blood Glucose Self-Monitoring
Home Blood Glucose Monitoring
Personal Health Record (PHR)
Health Information Technology (HIT)
Care management
Disease Management
Diabetes self-management
Consumer Health Information
Medical Records Systems, Computerized
Computerized Medical Records System
Automated Medical Records System
Electronic Health Record (EHR)
Remote patient monitoring

Additional relevant MeSH terms:
Diabetes Mellitus
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases