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The Use of a Computer Program to Help Primary Care Providers Treat Patients With Type 2 Diabetes (CADS)

24. november 2015 opdateret af: Alicia L. Warnock, Walter Reed National Military Medical Center

The Use of a Computer Assisted Diabetes Decision Support (CADS) System to Improve Outcomes in Patients With Type 2 Diabetes Who Are Treated by Primary Care Providers

The primary purpose of this study is to determine whether the use of CADS by primary care providers (PCPs) for their patients with type 2 diabetes (T2DM) changes the quality of care relative to a "usual care" group in terms of objective outcome measures of glycemic control (e.g., A1c, mean blood glucose, frequency of hypoglycemic episodes) and in terms of subjective ratings by patients.

Studieoversigt

Status

Afsluttet

Detaljeret beskrivelse

The CADS software integrates the patient's home blood glucose data with appropriate laboratory data (e.g. A1c, liver function, kidney function), demographic data (age, gender), current and previous medications, and active/inactive medical diagnoses. The software makes a recommendation about what medication changes are appropriate with potential alternates. Providers with their patients are block randomized into CADS or "Usual Care" for 1 year.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

28

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Maryland
      • Bethesda, Maryland, Forenede Stater, 20889
        • Walter Reed National Military Medical Center

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Non-specialist physician (general internist or family practitioner), nurse practitioner, physicians assistant
  • Absence of orders for deployment or permanent change of station
  • Willingness to recruit up to 19 patients prior to randomization
  • Willingness to deliver "usual care" as defined in Section 6.3.2 of the protocol.

Exclusion Criteria:

  • Specialist physicians
  • Orders for deployment or permanent change of station
  • Unwillingness to recruit up to 19 patients prior to randomization
  • No prior experience with management of type 2 diabetes in adults
  • Unwillingness to deliver "usual care" as defined in Section 6.3.2 of the protocol.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Computer-Assisted Decision Support
These providers will use the CADS program to treat their enrolled patients.
The CADS software makes a recommendation about what medication changes are appropriate with potential alternates. CADS providers will either "accept" or "reject" the recommendation by the software.Providers with their patients are block randomized into CADS or "Usual Care" for 1 year. Patients associated with a CADS provider will upload their blood glucose data weekly and perform a 7-point glucose profile once per month. They will report major hypoglycemic events and hospitalizations at the time of their quarterly visit. Those getting "usual care" will be seen quarterly and will do self-monitoring of blood glucose and have A1c tests as determined by the provider but no less than twice a year.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in A1c
Tidsramme: baseline, 12, 24, 36, and 48 months
Change is A1c will be measured 5 times over the course of the study to compare the patients for whom the provider is using CADS to those patients whose providers are delivering "usual care".
baseline, 12, 24, 36, and 48 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Major events
Tidsramme: ongoing
The number of major ("severe") hypoglycemic events whether subjective (undocumented) or objective (SMBG or other confirmation, need for intervention, seizure, coma), and emergency room visits for DM-related causes.
ongoing
Other DM-related events
Tidsramme: ongoing
Number of ER visits for DM-related causes, DM-related hospitalizations and hospital days, and DM-related clinic visits.
ongoing
Glucose measures
Tidsramme: baseline, 12, 24, 36, 48 months
Mean pre-prandial glucose, mean post-prandial glucose, post-prandial glucose excursions
baseline, 12, 24, 36, 48 months
Blood pressure
Tidsramme: baseline, 12, 24, 36, and 48 months
Clinically significant or statistically detectable changes in BP
baseline, 12, 24, 36, and 48 months
Lipids
Tidsramme: baseline, 12, 24, 36, and 48 months
Clinically significant or statistically detectable changes in lipid profile.
baseline, 12, 24, 36, and 48 months
Patient satisfaction with treatment
Tidsramme: basline and 48 months
Clinically significant or statistically detectable changes in satisfaction with treatment as measured by the DTSQ.
basline and 48 months
Quality of life
Tidsramme: baseline and 48 months
Clinically significant or statistically detectable changes in quality of life for patients with DM as measured by the SF-8.
baseline and 48 months
Degree of Acceptance
Tidsramme: baseline and 48 months
The degree of acceptance of CADS by PCPs as measured by a technical assessment questionnaire.
baseline and 48 months
Acceptance of uploading data
Tidsramme: baseline, 12, 24, 36, and 48 months
The degree of acceptance of uploading the glucose meters by patients as measured by a technical assessment questionnaire.
baseline, 12, 24, 36, and 48 months
Demographic variables
Tidsramme: baseline and 48 months
The relationship of the primary and/or secondary outcomes to the type of provider, board-certification or eligibility, years in practice, age and gender.
baseline and 48 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Ledende efterforsker: Robert A Vigersky, M.D., Walter Reed National Military Medical Center

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. marts 2012

Primær færdiggørelse (Faktiske)

1. marts 2015

Studieafslutning (Faktiske)

1. marts 2015

Datoer for studieregistrering

Først indsendt

17. juli 2012

Først indsendt, der opfyldte QC-kriterier

19. juli 2012

Først opslået (Skøn)

24. juli 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

25. november 2015

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

24. november 2015

Sidst verificeret

1. november 2015

Mere information

Begreber relateret til denne undersøgelse

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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