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N/A N=762 Randomized Health Services Research

Nurse Telephone Management of Cholesterol in Diabetes

Type 1 Diabetes · Type 2 Diabetes

Enrolled (actual)
762
Serious AEs
0.0%
Results posted
Aug 2009
Primary outcome: Primary: Number of Patients With a Low Density Lipid (LDL) Value Less Than 100 mg/dL — 223; 178 Participants

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Phone Counseling (Behavioral); Standard Clinical Care (Other)
Age
Pediatric, Adult, Older Adult · 17+ yrs
Sex
All
Sponsor
Denver Health and Hospital Authority
Primary completion
May 2007

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Patients With a Low Density Lipid (LDL) Value Less Than 100 mg/dL
223; 178
SECONDARY
Number of CVD Patients With LDL Less Than 70 mg/dL.
41; 31
SECONDARY
Number of Patients With BP Less Than 130/80 mm Hg
168; 191
SECONDARY
Number of Patients With Hgb A1c Less Than 7 Percent at the End of the Study
62; 59

Summary

The current project is evaluating the effect of a nurse-administered phone care in diabetes to improve access to care and healthcare delivery. The setting is a federally qualified community health center serving over 1600 diabetic patients, 80% of whom are Latino. Using our diabetes registry, we have randomly assigned 762 patients to either participate in a telephone-based, nurse-run outreach program (N=381) or to continue with usual care(N=381). Three of our registered nurses learned algorithms addressing management of cholesterol, blood pressure, kidney disease, aspirin use, eye screening, and pneumovax and influenza vaccines. The program began recruitment in September 2005 and has finished follow up in May 2007. The program initially focused only on cholesterol management utilizing national guidelines and algorithms on patients with elevated cholesterol (LDL) levels but has expanded to include glycemic and blood pressure control. We found that Registered Nurses were able and willing to provide telephone care to diabetic patients according to moderately complex algorithms and to track patient data electronically with overall job satisfaction. Overall, the nurses have expressed enthusiasm but have also experience frustrations with maintaining contact and improving motivation in patients. The impact of this program on diabetes outcomes and its cost-effectiveness is currently being analyzed with the goal of implementing this program in our institution.

Eligibility Criteria

Inclusion Criteria

  • Patients included in Denver Health diabetes registry.
  • Type I and Type II diabetic patients
  • Age >17 years old
  • Actively utilizing Westside Clinic for their primary care (at least two visits in the past year)
  • Speak either English or Spanish.

Exclusion Criteria:We sought to maximize the generalizability of the study and therefore had only minimal exclusion criteria:

  • Pregnant or lactating women
  • Patients with end-stage renal disease (creatinine > 3.0 mg/dl)
  • Patients with a co-morbid illness with life expectancy less than 12 months, (e.g. terminal cancer or Child's Class C hepatic cirrhosis).
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00950963). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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