- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03889600
Re-Engineered Discharge for Diabetes-Computer Adaptive Testing (REDD-CAT)
March 2, 2023 updated by: Boston Medical Center
Addressing Social Determinants in Diabetes Care: The REDD-CAT Health-related Social Needs Screening Tool
Over 27 million Americans are diagnosed with Type 2 Diabetes Mellitus (T2DM), and their health outcomes, including hospitalization, emergency department use, and hospital readmission, are largely driven by social determinants; diabetes complications are largely attributable to unmet health-related social needs.
Investigators will conduct a pilot feasibility trial of the Re-Engineered Discharge for Diabetes-Computer Adaptive Testing (REDD-CAT) system to inform the design of a future, fully-powered randomized controlled trial.
REDD-CAT will allow clinical staff to preemptively link patients with community-based social services tailored to meet their unique needs in order to reduce avoidable hospitalization and emergency department visits.
Study Overview
Detailed Description
Investigators will conduct a pilot study with 30 patients to evaluate the feasibility and limited efficacy of the REDD-CAT social service screening and referral intervention to inform the design of a fully-powered trial.
The study will determine the feasibility of delivering the REDD-CAT intervention in a clinical, point-of-care context to inform the design and implementation strategy for a fully powered clinical trial.
It is not the purpose of this pilot clinical trial to determine sample size for a larger, fully-powered trial, as investigators already have data from prior readmissions research supporting sample size and power estimates using readmission rates as a primary outcome measure.
After obtaining informed consent from a participant and gathering baseline data, the study research assistant (RA) will send a flag in the electronic medical record (EMR) to notify the nurse care manager that a patient has enrolled in the REDD-CAT pilot.
The nurse care manager will then incorporate the administration of the REDD-CAT to the patient as part of standard care discharge planning.
He or she will utilize the REDD-CAT results report as a guideline for generating appropriate referrals to address unmet social needs identified.
To inform secondary measure selection for a future larger study, the RA will administer to enrolled patients a number of standardized measures, including the PHQ-9, GAD-7, Ways of Coping Questionnaire, and Diabetes Distress Scale.
All baseline measures will be re-administered at 30-day follow-up to patients via the telephone.
Data on hospitalizations and ED visits during the 30-day period post-discharge will be obtained from patients' medical records, and all data gathered will be stored in a REDCap electronic database.
Study Type
Interventional
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Massachusetts
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Boston, Massachusetts, United States, 02118
- Boston Medical Center
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Boston Medical Center inpatient
- Lives in the greater Boston area
- Diagnosis of Type 2 diabetes
- English- speaking
- Demonstrated willingness and capacity to consent
- Age 18 or older
- Has reliable telephone access
Exclusion Criteria:
- Currently pregnant
- Has plans to leave the area for >2 weeks in the 45 days following enrollment in the study
- Diagnosis of dementia, memory loss, or memory deficit
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: REDD-CAT Recipient
The nurse care manager will incorporate the administration of the REDD-CAT to the patient as part of the standard care discharge planning.
He or she will utilize the REDD-CAT results report as a guideline for generating appropriate referrals to address unmet social needs identified.
|
After obtaining informed consent from a participant and gathering baseline data, the study RA will send a flag in the EMR to notify the nurse care manager that a patient has enrolled in the REDD-CAT pilot.
The nurse care manager will then incorporate the administration of the REDD-CAT to the patient as part of standard care discharge planning.
He or she will utilize the REDD-CAT results report as a guideline for generating appropriate referrals to address unmet social needs identified.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility - Recruitment potential: percentage of eligible patients willing to enroll in the study
Time Frame: 6 months
|
Recruitment potential will be measured according to the percentage of eligible patients willing to enroll in the study.
The source of this outcome data will be the hospital census and recruitment data.
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6 months
|
Feasibility - Participant burden: time required for participants to complete data collection measures
Time Frame: 6 months
|
Participant burden will be measured according to the time required for participants to complete data collection measures; the data source will be data collected by research assistants
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6 months
|
Feasibility - Subject retention: percentage of patients who complete the 30-day follow-up time point
Time Frame: 30 days
|
Retention will be measured according to the percentage of patients who complete the 30-day follow-up time point; study records will provide this data.
|
30 days
|
Feasibility - Implementation fidelity: percentage of indicated referrals that are made
Time Frame: 30 days
|
Implementation fidelity will be measured according to the percentage of indicated referrals that are made; discharge records and electronic medical records will provide this data.
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30 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Limited Efficacy - Change in coping: Ways of Coping scale
Time Frame: baseline, 30 days
|
Coping will be assessed using the Ways of Coping scale which is a 66 item scale with potential responses from 1 to 4, with higher scores indicative of more frequent use of a particular strategy.
|
baseline, 30 days
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Limited Efficacy - Change in diabetes related distress: Diabetes Distress scale
Time Frame: baseline, 30 days
|
Diabetes related stress will be assessed using the Diabetes Distress scale which comprises 17 items with potential responses ranging from 1 to 6, with lower scores indicating that an item is less of a problem and higher scores indicating that an item poses a greater problem.
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baseline, 30 days
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Limited Efficacy - Change in depression: Patient Health Questionnaire (PHQ-9)
Time Frame: baseline, 30 days
|
Change in depression will be assessed using the Patient Health Questionnaire (PHQ-9), which is a 9-item questionnaire that asks how often an individual has been bothered by a given item over the last 2 weeks.
Scores range from 0 ("not at all") to 3 ("nearly every day.")
A higher overall score indicates a greater level of depression.
|
baseline, 30 days
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Limited Efficacy - Change in anxiety: The Generalized Anxiety Disorder 7 (GAD-7)
Time Frame: baseline, 30 days
|
The Generalized Anxiety Disorder 7 (GAD-7) will be used to assess changes in anxiety.
The GAD-7 is a 7-item questionnaire that asks how often an individual has been bothered by a given item over the last 2 weeks.
Scores range from 0 ("not at all") to 3 ("nearly every day.")
A higher overall score indicates a greater level of anxiety.
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baseline, 30 days
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Limited Efficacy - 30-Day readmission rate
Time Frame: 30 days
|
30-Day readmission rate will be measured according to the percent difference between readmission rates for a historical control versus pilot readmission rates; this data will be collected via the EMR and clinical data warehouse
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30 days
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Process Outcome- Referral Completion: percentage of patients who receive services post-referral
Time Frame: 30 days
|
Referral Completion will be measured by the percentage of patients who receive services post-referral
|
30 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Suzanne E Mitchell, MD, Boston Medical Center
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Anticipated)
March 2, 2021
Primary Completion (Anticipated)
April 13, 2021
Study Completion (Anticipated)
April 13, 2021
Study Registration Dates
First Submitted
March 22, 2019
First Submitted That Met QC Criteria
March 25, 2019
First Posted (Actual)
March 26, 2019
Study Record Updates
Last Update Posted (Estimate)
March 6, 2023
Last Update Submitted That Met QC Criteria
March 2, 2023
Last Verified
March 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- H-38545
- R21DK121092 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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