CClinicalTrials.gg
CompletedNCT00357955Updated Nov 7, 2024Results posted

Combined Behavioral and Pharmacological Intervention for Cardiovascular Risk Reduction in Diabetic Patients

An interventional study of Behavioral counseling and peer support and Interactive Education in Diabetes, Hypertension and Dyslipidemia, sponsored by Providence VA Medical Center. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-11-07.

Sponsored by Providence VA Medical Center · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
118
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this research is to study whether a multidisciplinary education in Diabetes and intervention for cardiac risk reduction in a group setting to modify patient behavior and adjust medications can achieve diabetes guideline goals for glycemia, blood pressure and lipid control.

02

Conditions studied

  • Diabetes
  • Hypertension
  • Dyslipidemia
  • Coronary Arteriosclerosis
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • All diabetic veterans with a Hb-A1c between 7.0- 9.0 % within the last 6 months will be eligible for the study

Exclusion criteria

Exclusion Criteria:

  • Patients without an Hb-A1c checked within the last 6 months.
  • Patients who are unable to attend the group sessions, either because of lack of transportation, psychiatric instability (suicidal, psychotic), or organic brain injury that preclude them from diabetes self-care.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
118 participants (actual)

Study arms

  • Experimental
    MEDIC

    Multidisciplinary education and diabetes intervention for cardiac risk reduction

    Behavioral: Behavioral counseling and peer support · Behavioral: Interactive Education · Behavioral: Role modeling · Procedure: Pharmacologic case management

  • No intervention
    usual care

    usual care

Interventions

  • BehavioralBehavioral counseling and peer support

    Multidisciplinary education and diabetes intervention for cardiac risk reduction - pharmacist led group intervention

  • BehavioralInteractive Education

    interactive lectures with hands-on learning

  • BehavioralRole modeling

    learning from peers with similar disease and problems

  • ProcedurePharmacologic case management

    provided by clinical pharmacists following pre-established algorithms

05

What researchers measure

Primary outcomes

  1. Percentage of Participans With A1c<7%, LDL Cholesterol <100mg/dL, Systolic Blood Pressure <130mm Hg and Diastolic Blood Pressure <80 mm Hg

    The major outcome was the percentage of participants who attain the target goals for A1C, blood pressure,and ldl cholesterol lipids set by the American Diabetes Association guidelines, defined as A1C \<7%, SBP \<130 mm Hg, diastolic blood pressure (DBP) \<80 mm Hg, and LDL cholesterol \<100 mg/dL (2.6 mmol/L).

    Time frame: 4 months

06

Results

Posted May 13, 2014

Participant flow

Eligible patients were identified by a combination of the review of the VA Medical Center's electronic medical record system and referral by primary care providers. Recruitment started July 2004 and enrollment was completed by May 2007.

Participant flow — Overall Study
MilestoneMEDICUsual Care
Started6454
Completed5851
Not completed63

Outcome measures

PrimaryPercentage of Participans With A1c<7%, LDL Cholesterol <100mg/dL, Systolic Blood Pressure <130mm Hg and Diastolic Blood Pressure <80 mm Hg

The major outcome was the percentage of participants who attain the target goals for A1C, blood pressure,and ldl cholesterol lipids set by the American Diabetes Association guidelines, defined as A1C \<7%, SBP \<130 mm Hg, diastolic blood pressure (DBP) \<80 mm Hg, and LDL cholesterol \<100 mg/dL (2.6 mmol/L).

Time frame:
4 months
Reported as:
Number · percentage
Percentage of Participans With A1c<7%, LDL Cholesterol <100mg/dL, Systolic Blood Pressure <130mm Hg and Diastolic Blood Pressure <80 mm Hg
percentageMEDICUsual Care
A1c <7%40.421.6
Systolic Blood Pressure<130mmHg65.539.9
Diastolic Blood Pressure<80mmHg87.968.6
LDL Cholesterol <100mg/dL77.277.5

Adverse events

Collected over Adverse events were documented and reported for the complete study duration of 4 months and 1 month post completion of the study.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
MEDIC—0/58 (0%)11/58 (19%)
Usual Care—1/51 (2%)2/51 (3.9%)
Most frequent serious events
Most frequent serious events
EventMEDICUsual Care
HospitalizationCardiac disorders0/581/51
Most frequent other events
Showing 10 of 13
Most frequent other events
EventMEDICUsual Care
CoughRespiratory, thoracic and mediastinal disorders1/581/51
hypoglycemiaBlood and lymphatic system disorders0/581/51
Lower Back PainMusculoskeletal and connective tissue disorders1/580/51
SyncopeCardiac disorders1/580/51
Cellulitis AbcessSkin and subcutaneous tissue disorders1/580/51
LacerationSkin and subcutaneous tissue disorders1/580/51
BlepharitisEye disorders1/580/51
Toe infectionSkin and subcutaneous tissue disorders1/580/51
Ear acheEar and labyrinth disorders1/580/51
BronchitisRespiratory, thoracic and mediastinal disorders1/580/51

Baseline characteristics

Age, mean in years; Gender, % male; Baseline level of glycemic control

Age, Categorical
Age, Categorical(Participants)MEDICUsual CareTotal
<=18 years000
Between 18 and 65 years392059
>=65 years193150
Age, Continuous
Age, Continuous(years)MEDICUsual CareTotal
Mean62 ± 10.366.8 ± 10.264.4 ± 10.5
Sex: Female, Male
Sex: Female, Male(Participants)MEDICUsual CareTotal
Female505
Male5351104
Region of Enrollment
Region of Enrollment(participants)MEDICUsual CareTotal
United States5851109
07

Study locations

1 site
  • Providence VAMC
    Providence, Rhode Island 02908, United States
08

References and documents

Publications

  • Taveira TH, Friedmann PD, Cohen LB, Dooley AG, Khatana SA, Pirraglia PA, Wu WC. Pharmacist-led group medical appointment model in type 2 diabetes. Diabetes Educ. 2010 Jan-Feb;36(1):109-17. doi: 10.1177/0145721709352383. Epub 2009 Dec 4. PubMed 19966072 ↗
  • Khatana SA, Taveira TH, Choudhary G, Eaton CB, Wu WC. Change in hemoglobin A(1c) and C-reactive protein levels in patients with diabetes mellitus. J Cardiometab Syndr. 2009 Spring;4(2):76-80. doi: 10.1111/j.1559-4572.2008.00042.x. PubMed 19614793 ↗
09

Registry details

Key details

Study ID
NCT00357955
Lead sponsor
Providence VA Medical Center
Collaborators
Rhode Island Foundation
Responsible party
Wen-Chih Wu (Staff Cardiologist, Providence VA Medical Center) — Principal investigator
First posted
Jul 28, 2006
Start date
Aug 2004
Primary completion
May 2008
Completion
May 2008
Results posted
May 13, 2014
Last update
Nov 7, 2024

Study contacts

Wen-Chih Wu, MD
principal investigator · Providence VAMC

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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