- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT06740435
Étude pilote améliorant la télémédecine pour le DT2
Étude pilote améliorant la prestation de soins par télémédecine pour les adultes atteints de diabète de type 2 complexe
The goal of this pilot clinical trial is to assess feasibility of an intervention to deliver comprehensive, high-quality diabetes care through telemedicine among adults with type 2 diabetes who use insulin and have multiple chronic health conditions. The main question it aims to answer is:
Is an enhanced telemedicine intervention for type 2 diabetes compared to usual telemedicine care feasible?
Researchers will compare the enhanced telemedicine intervention to usual telemedicine care to see if there are differences in patient satisfaction or preliminary clinical outcomes.
Participants will complete 2-3 telemedicine diabetes care visits over approximately 6 months, as well as complete survey measures with each diabetes care visit. Patients in the intervention group will also receive additional support, including pre-visit preparation phone calls, diabetes self-management education and support aligned with their visits, and post-visit follow-up calls.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
This pilot study will compare an intervention to deliver high-quality diabetes care through telemedicine for adults with type 2 diabetes who have additional chronic health conditions and use insulin with usual telemedicine care. The investigators will assess feasibility, patient satisfaction, and preliminary clinical outcomes.
Fifty adults will be recruited from primary care practices. Once patients are confirmed eligible, they will be consented and enrolled. Patients will be randomized to the intervention arm or usual telemedicine care, stratified by age (above or below 65 years) and rurality, as these factors are associated with technological literacy and broadband access, which may impact telemedicine use and outcomes. Both groups will complete baseline survey measures and baseline clinical data will be collected via chart review. As this is a pragmatic pilot trial, intervention components will be delivered by usual clinical providers and staff for the intervention group. The telemedicine care intervention will include 2-3 synchronous visits with endocrinology providers over 6 months plus additional visits with multidisciplinary providers on an individualized basis. Telemedicine care will proceed as usual for the control group.
The investigators will focus pilot trial outcomes on standard metrics to assess feasibility for a future large trial. The investigators will also measure preliminary clinical outcomes.
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
-
-
Pennsylvania
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Pittsburgh, Pennsylvania, États-Unis, 15213
- University of Pittsburgh
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- adults 18 years or older
- Diagnosis of type 2 diabetes based on abbreviated ICD-10 code E11.X in medical record or self-report
- HbA1c greater than or equal to 8% based on most recent value at time of recruitment
- Patients must own or have access to a smart phone, tablet, or home computer with data or internet connection that allows access to video-based visits
- Patient must use insulin
- Patients must have >2 comorbid chronic health conditions
- Be able to provide informed consent
- Reside in Pennsylvania
Exclusion criteria:
-
Age over 80 based on date of birth in electronic medical record
-
Visit with an endocrinologist in the prior 1 years
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Dementia, ESRD, malignancy based on abbreviated ICD-10 codes below in medical record or self-report of associated condition
- Dementia: A81.0x, F01.5x, F02.8x, F03.9x, F10.27, F10.97, F13.27, F13.97, F18.97, F19.17, F19.27, F19.97, G30.x, G31.0x, G31.1, G31.83, G31.85
- Malignancy, except non-melanoma skin cancer: C00.x-C14.x, C15.x-C26.x, C3x.xx, C40.xx-C41.x, C43.x, C4A.xx, C45.x-C49.xx, C50.xxx, C51.x-C58, C60.x-C63.x, C64.x- C68.x, C69.xx-C72.x, C73-C76.x, C7A.xx, C80.xx-C96.x (except C90.x1, C91.x1, C92.x1, C93.x1, C94.x1, C95.x1)
- ESRD N18.6
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Type 1, gestational, or other diabetes based on abbreviated ICD-10 codes below in medical record or self-report of associated condition
- Type 1 diabetes: E10.X
- Gestational diabetes: O24.X, E08.X
- Other diabetes: E09.X, E13.2
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Pregnant or planning to become pregnant in next 6 months
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Currently enrolled in another diabetes management intervention study
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Recherche sur les services de santé
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Enhanced Telemedicine Care
Specialty care for type 2 diabetes delivered via telemedicine by an endocrinologist, with additional multidisciplinary support from the diabetes care team. |
Telemedicine-based endocrinology specialty care for type 2 diabetes with multidisciplinary diabetes care team support including pre-visit preparation, in-visit support and self-management education, and post-visit follow-up. |
|
Comparateur actif: Usual Care
Specialty care for type 2 diabetes delivered via telemedicine by an endocrinologist following usual clinical care protocols. |
Routine telemedicine-based endocrinology specialty care for type 2 diabetes, generally consisting of synchronous virtual visit with an endocrinologist and additional support including self-management education on an individualized basis. |
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Recruitment percentage
Délai: 12 months
|
Percent of eligible patients approached who are enrolled |
12 months
|
|
Loss to follow up
Délai: 6 months
|
Percent of enrolled patients who do not complete study, defined as not completing at least 2 study visits and associated surveys |
6 months
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Recruitment rate
Délai: 12 months
|
Number of patients recruited per month |
12 months
|
|
Eligibility percentage
Délai: 12 months
|
Percent of patients approached who are eligible |
12 months
|
|
Visit attendance
Délai: 6 months
|
Percent of scheduled visits completed per patient |
6 months
|
|
Number of between-visit contacts
Délai: 6 months
|
Number of successful and attempted patient contacts by clinicians between visits per patient |
6 months
|
|
Blood glucose data availability
Délai: 6 months
|
Number of telemedicine visits with blood glucose data available at visit per patient |
6 months
|
|
Patient satisfaction with telemedicine diabetes care
Délai: 6 months
|
Percent of patients reporting satisfied or very satisfied on a 5-point Likert scale ranging from 1 "strongly disagree" to 5 "strongly agree" with the statement "Overall, I am satisfied with the quality of service being provided via telemedicine" with higher scores indicating greater satisfaction |
6 months
|
|
Diabetes Treatment Satisfaction Questionnaire-static version
Délai: Baseline
|
Total score of 8-item measure of global satisfaction with diabetes treatment regimen. The static version will be used at baseline. Items 1, 4, 5, 6, 7 & 8 are summed to produce a Treatment Satisfaction score (range:0 to 36). The higher the score, the greater the satisfaction with treatment. 'Perceived frequency of hyperglycaemia' (item 2) & 'Perceived frequency of hypoglycaemia' (item 3): Both rated: 6 ('most of the time') to 0 ('none of the time'). Here, lower scores indicate blood glucose levels closer to the ideal. Higher scores indicate problems. |
Baseline
|
|
Diabetes Treatment Satisfaction Questionnaire-change version
Délai: 6 months
|
Total score of 8-item measure of global satisfaction with diabetes treatment regimen. The change version will be used at 6 months.Items 1, 4, 5, 6, 7 and 8 are summed to produce a Treatment Satisfaction (change) score (range: +18 to -18). The higher the score, the greater the improvement in satisfaction with treatment; the lower the score, the greater the deterioration in satisfaction with treatment. A score of 0 represents no change. Two remaining items ('Perceived change in frequency of hyperglycaemia' (item 2) and 'Perceived change in frequency of hypoglycaemia' (item 3)) are treated individually: Both rated: +3 ('much more of the time now') to -3 ('much less of the time now'). Here, negative scores indicate fewer problems with blood glucose levels. Positive scores indicate more problems than before. |
6 months
|
|
T2D Diabetes Distress Core Scale
Délai: Baseline and 6 months
|
Change in total score of 8-item measure of diabetes-related distress over prior month from baseline to 6 months. The Diabetes Distress Core scale is scored by averaging the value for each item, ranked from 1 to 5 scale (score range 1-5), with higher scores indicating more distress. |
Baseline and 6 months
|
|
HbA1c change
Délai: Baseline and 6 months
|
Change in glycemic control from baseline to 6 months |
Baseline and 6 months
|
|
Prescription of guideline-based GLP-1 receptor agonist
Délai: Baseline and 6 months
|
Number of patients with indications for GLP-1 receptor agonist therapy who are prescribed the indicated medication |
Baseline and 6 months
|
|
Prescription of guideline-based SGLT2 inhibitor
Délai: Baseline and 6 months
|
Number of patients with indications for SGLT2 inhibitor therapy who are prescribed the indicated medication |
Baseline and 6 months
|
|
Retinal examination
Délai: 6 months
|
Number of patients with documentation of retinal examination performed in last year in medical record |
6 months
|
|
Urine protein testing
Délai: 6 months
|
Number of patients with documentation of urine protein testing performed in last year in medical record |
6 months
|
|
Immunization-pneumococcal
Délai: 6 months
|
Number of patients with documentation of pneumococcal vaccination in medical record |
6 months
|
|
Immunization-influenza
Délai: 6 months
|
Number of patients with documentation of influenza vaccination in medical record |
6 months
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Margaret Zupa, MDMS, University of Pittsburgh
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- STUDY24060062
- K23DK135794 (Subvention/contrat des NIH des États-Unis)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
A deidentified dataset including limited demographic, encounter, laboratory result, clinical observations, medication orders, care utilization, and survey (intervention satisfaction, treatment satisfaction, diabetes distress) data will be created. To protect research participant identities, datasets will not include any potentially identifying participant information.
Délai de partage IPD
The data will become available no later than 12 months and ending 36 months after the primary trial results are published.
Critères d'accès au partage IPD
No access will be granted until the requesting investigator vetting process is completed including an IRB-approved protocol and data use agreement with the University of Pittsburgh.The data that may be shared includes: de-identified participant data, tables, figures, appendices, analysis plan, and protocol.
Type d'informations de prise en charge du partage d'IPD
- PROTOCOLE D'ÉTUDE
- SÈVE
- CIF
Informations sur les médicaments et les dispositifs, documents d'étude
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