The Virtual Visit for Women With Gestational Diabetes
2019年2月4日 更新者:Kaiser Permanente
This is a feasibility study of care for women with gestational diabetes (GDM) using electronic equipment to participate in virtual office visits.
Participants will be trained in the use of glucose meters, scales, and sphygmomanometers which are Bluetooth connected to an app on their cellphones. Fetal well-being will be assessed with Dopplers and kick counts. Care will be delivered by alternate in-office and telephone visits.
研究概览
地位
完全的
条件
详细说明
The core elements of a prenatal visit for any pregnant woman include assessment of BP, weight, and presence of fetal heart activity.
The treatment of GDM additionally requires the measurement of and review of maternal glycemia.
Technology exists for patients to measure these parameters and to relay this information securely directly from these devices via the internet to the healthcare provider's office.
A key element of antepartum care for GDM, self-monitoring of blood glucose (SMBG), has for some years been conducted with memory-based portable glucose meters.
To assure accuracy in reports of patient measurements, it is important that all devices be of a design wherein results of measures of patient parameters are transmitted in unedited fashion directly devices to the health care provider.
While no data exists about the accuracy of self-reporting of patient weight and blood pressure, intentional or unintentional alteration in reports of self-monitored glucose results is a known risk of reliance on patient self-reported data.
This pilot study will explore the feasibility of the use of this technology from patients' homes in lieu of an office visit.
研究类型
介入性
注册 (实际的)
10
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
-
-
California
-
Pasadena、California、美国、91101
- Kaiser Permanente Southern California
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-
参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 45年 (成人)
接受健康志愿者
是的
有资格学习的性别
女性
描述
Inclusion Criteria:
- Diagnosis of gestational diabetes
- Singleton pregnancy
- <32 weeks gestation
- Age 18-45 years
- Fluent and literate in English or Spanish
- Have a cellphone with capability of internet access.
Exclusion Criteria:
- Multiple gestations (twins or higher)
- Have a history of fetal demise
- Have a history of chronic health problems that might affect outcomes (such as HIV, treatment with steroids, significant cardiac or renal disease, or chronic hypertension), and those who had bariatric surgery.
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:诊断
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
实验性的:Virtual visit
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Self-monitoring of blood glucose 4 times daily: fasting and 1-hour after each meal.
Results will be recorded and transmitted in real-time via a Bluetooth connection to a cellphone app installed on study enrollment.
Intervention: At every office visit and at every telephone ("virtual") visit the patient's physician will review glucose results and make adjustments in diet, activity, or medication to bring glucose into desired range.
Self-weighing on electronic scale at least once a week.
Results will be recorded and transmitted in real-time via a Bluetooth connection to a cellphone app installed on study enrollment.
Consultation with the nutritionist will be obtained for women gaining in excess of or less than that indicated for her pre-pregnancy BMI, per Institute of Medicine (IOM) standards.
Self-checking of blood pressure at least weekly with sphygmomanometer.
Results will be recorded and transmitted in real-time via a Bluetooth connection to a cellphone app installed on study enrollment.
Patients with elevated blood pressure will be requested to come to Obstetrics Triage immediately for further assessment.
Patient will record her fetus' heart rate with a Doppler device at least once weekly.
The patient will immediately report to Labor and Delivery for any fetal heart rate below 100 beats per minute or greater than 160 beats per minute over a 10 minute observation period.Those reporting a fetal heart rate outside of the normal range will be requested to come to ObstetricTriage for further assessment.
Telephone visits will alternate with in-office visits.Those failing to keep appointments will be contacted and reappointed at a mutually convenient time.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Compliance With Requirements for Frequency of Glucose Measures
大体时间:1 year
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Each patient is requested to check her blood glucose four times a day: fasting and one hour after the first bite of each meal.
Compliance with this requirement will be measured for each patient by dividing the number of daily glucose checks actually performed by the number of days in the study.
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1 year
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Compliance With Self-weighing Requirements
大体时间:1 year
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Average percentage of weight checks per week in study, calculated as total weight checks in study/weeks in study x 100
|
1 year
|
Compliance With Blood Pressure Checking Requirements
大体时间:1 year
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Percentage of required once-weekly blood pressure checks calculated as total blood pressure checks in study/weeks in study x 100
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1 year
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Glucose Concentrations
大体时间:1 year
|
Mean of all glucose measures during study, in mg/dl
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1 year
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员:David A Sacks, MD、Kaiser Permanente
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Given JE, Bunting BP, O'Kane MJ, Dunne F, Coates VE. Tele-Mum: A Feasibility Study for a Randomized Controlled Trial Exploring the Potential for Telemedicine in the Diabetes Care of Those with Gestational Diabetes. Diabetes Technol Ther. 2015 Dec;17(12):880-8. doi: 10.1089/dia.2015.0147. Epub 2015 Sep 22.
- Homko CJ, Deeb LC, Rohrbacher K, Mulla W, Mastrogiannis D, Gaughan J, Santamore WP, Bove AA. Impact of a telemedicine system with automated reminders on outcomes in women with gestational diabetes mellitus. Diabetes Technol Ther. 2012 Jul;14(7):624-9. doi: 10.1089/dia.2012.0010. Epub 2012 Apr 18.
- Sacks DA, Ling Grant D, Macias M, Li X, Lawrence JM. The Virtual Office Visit for Women With Gestational Diabetes Mellitus. Diabetes Care. 2017 Mar;40(3):e34-e35. doi: 10.2337/dc16-2569. Epub 2017 Jan 11. No abstract available. Erratum In: Diabetes Care. 2019 Apr;42(4):701.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2014年9月1日
初级完成 (实际的)
2016年9月1日
研究完成 (实际的)
2016年9月1日
研究注册日期
首次提交
2016年10月18日
首先提交符合 QC 标准的
2016年11月7日
首次发布 (估计)
2016年11月9日
研究记录更新
最后更新发布 (实际的)
2019年2月26日
上次提交的符合 QC 标准的更新
2019年2月4日
最后验证
2019年2月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.