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Sponsored by: |
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) |
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Information provided by: | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) |
ClinicalTrials.gov Identifier: | NCT00308386 |
Although strong clinical evidence exists that patients with diabetes should achieve certain clinical goals (i.e. HbA1C, BP, LDL, etc.), to reduce morbidity and mortality national surveys indicate that only a minority of people with diabetes achieves these goals.
Hypothesis: combination of nurse case management and enhanced behavior change counseling will improve outcomes for glycemic control, blood pressure and cholesterol in high risk patients with Type 2 diabetes when compared to usual care over a 3 year period.
Study design- The study will be a three year randomized control trial that will select patients that have either A1C >8.5, LDL >130, or BP >140/90. Nurse case managers, trained in clinical guidelines and brief behavior change counseling techniques (motivational interviewing), will aim to foster patient adherence in the experimental group patients. Nurse case managers will use standing orders to set an implementation of clinical guidelines (for diabetes, hypertension, hyperlipidemia and depression) with individual follow up.
A total of 820 patients between the all 9 (6 Hershey Medical Center and 3 Reading Hospital affiliated clinics) will be sought. One third of the study patients will be recruied from the underserved Hispanic population in the Reading area. Patients will be randomized by physician i.e. one physician will be randomly assigned to have all their patients co-managed by a nurse case manager; the other will have usual care without any contact with nurse case manager.
Nurses will be trained and then initiate a small pilot study in July thru August. Full recruitment and initiation of study will begin in September 2006.
Clinic Activities - Each nurse will be responsible for 3 clinics. Nurses will work under the supervision of the primary care physicians. A set of clinical guidelines will be developed with physician input that will serve as the over-riding framework for the nurses.
Outcomes - Over a three-year period we will evaluate clinical response (improvements in A1C, BP, LDL, and depression when present) as well as a series of other measures that will be obtained by surveys (patient satisfaction, quality of life, self-management behaviors). Provider satisfaction will be measured using a standardized tool. Finally, cost effectiveness of the intervention and evaluation of the potential barriers to implementation will be studied.
Condition | Intervention | Phase |
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Diabetes Mellitus Hypertension Hyperlipidemia |
Behavioral: Nurse Case Management intervention |
Phase III |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study |
Official Title: | Impact of Nurse Case Management on Diabetes co-Morbidities |
Estimated Enrollment: | 820 |
Study Start Date: | August 2006 |
Estimated Study Completion Date: | August 2010 |
Estimated Primary Completion Date: | August 2010 (Final data collection date for primary outcome measure) |
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
United States, Pennsylvania | |
Penn State College of Medicine | |
Hershey, Pennsylvania, United States, 17033 | |
Reading Hospital | |
Reading, Pennsylvania, United States, 19612 |
Principal Investigator: | Robert Gabbay, MD, PhD | Penn State College of Medicine |
Responsible Party: | Penn State University College of Medicine ( Robert Gabbay, MD, Phd. ) |
Study ID Numbers: | 67495 |
Study First Received: | March 27, 2006 |
Last Updated: | August 19, 2008 |
ClinicalTrials.gov Identifier: | NCT00308386 |
Health Authority: | United States: Federal Government; United States: Institutional Review Board |
Nurse Case Management Diabetes Hypertension |
Hyperlipidemia Behavior therapy Motivational interviewing |
Metabolic Diseases Hyperlipidemias Vascular Diseases Diabetes Mellitus Endocrine System Diseases Endocrinopathy |
Metabolic disorder Glucose Metabolism Disorders Dyslipidemias Lipid Metabolism Disorders Hypertension |
Cardiovascular Diseases |