BACKGROUND: Diabetes outcomes are worse for underserved patients from certain ethnic/racial minority populations. Telephonic disease management is a cost-effective strategy to deliver self-management services and possibly improve diabetes outcomes for such patients. OBJECTIVE: We conducted a trial to test the effectiveness of a supplemental telephonic disease management program compared to usual care alone for patients with diabetes cared for in a community health center. DESIGN: Randomized controlled trial. PARTICIPANTS: All patients had type 2 diabetes, and the majority was Hispanic or African American. Most were urban-dwelling with low socioeconomic status, and nearly all had Medicaid or were uninsured. MEASUREMENTS: Clinical measures included glycemic control, blood pressure, lipid levels, and body mass index. Validated surveys were used to measure dietary habits and physical activity. RESULTS: A total of 146 patients were randomized to the intervention and 149 to the control group. Depressive symptoms were highly prevalent in both groups. Using an intention to treat analysis, there were no significant differences in the primary outcome (HbA1c) between the intervention and control groups at 12 months. There were also no significant differences for secondary clinical or behavioral outcome measures including BMI, systolic or diastolic blood pressure, LDL cholesterol, smoking, or intake of fruits and vegetables, or physical activity. CONCLUSIONS: A clinic-based telephonic disease management support for underserved patients with diabetes did not improve clinical or behavioral outcomes at 1 year as compared to patients receiving usual care alone.
RCT Entities:
BACKGROUND:Diabetes outcomes are worse for underserved patients from certain ethnic/racial minority populations. Telephonic disease management is a cost-effective strategy to deliver self-management services and possibly improve diabetes outcomes for such patients. OBJECTIVE: We conducted a trial to test the effectiveness of a supplemental telephonic disease management program compared to usual care alone for patients with diabetes cared for in a community health center. DESIGN: Randomized controlled trial. PARTICIPANTS: All patients had type 2 diabetes, and the majority was Hispanic or African American. Most were urban-dwelling with low socioeconomic status, and nearly all had Medicaid or were uninsured. MEASUREMENTS: Clinical measures included glycemic control, blood pressure, lipid levels, and body mass index. Validated surveys were used to measure dietary habits and physical activity. RESULTS: A total of 146 patients were randomized to the intervention and 149 to the control group. Depressive symptoms were highly prevalent in both groups. Using an intention to treat analysis, there were no significant differences in the primary outcome (HbA1c) between the intervention and control groups at 12 months. There were also no significant differences for secondary clinical or behavioral outcome measures including BMI, systolic or diastolic blood pressure, LDL cholesterol, smoking, or intake of fruits and vegetables, or physical activity. CONCLUSIONS: A clinic-based telephonic disease management support for underserved patients with diabetes did not improve clinical or behavioral outcomes at 1 year as compared to patients receiving usual care alone.
Authors: Susan L Norris; Phyllis J Nichols; Carl J Caspersen; Russell E Glasgow; Michael M Engelgau; Leonard Jack; George Isham; Susan R Snyder; Vilma G Carande-Kulis; Sanford Garfield; Peter Briss; David McCulloch Journal: Am J Prev Med Date: 2002-05 Impact factor: 5.043
Authors: Wayne Katon; Michael von Korff; Paul Ciechanowski; Joan Russo; Elizabeth Lin; Gregory Simon; Evette Ludman; Edward Walker; Terry Bush; Bessie Young Journal: Diabetes Care Date: 2004-04 Impact factor: 19.112
Authors: Laurie Ruggiero; Barth B Riley; Rosalba Hernandez; Lauretta T Quinn; Ben S Gerber; Amparo Castillo; Joseph Day; Diana Ingram; Yamin Wang; Paula Butler Journal: West J Nurs Res Date: 2014-02-25 Impact factor: 1.967
Authors: Kelsey A Luoma; Ian M Leavitt; Joel C Marrs; Andrea L Nederveld; Judith G Regensteiner; Andrea L Dunn; Russell E Glasgow; Amy G Huebschmann Journal: Transl Behav Med Date: 2017-12 Impact factor: 3.046
Authors: Robert A Gabbay; Raquel M Añel-Tiangco; Cheryl Dellasega; David T Mauger; Alan Adelman; Deborah H A Van Horn Journal: J Diabetes Date: 2013-05-28 Impact factor: 4.006
Authors: Shari D Bolen; Apoorva Chandar; Corinna Falck-Ytter; Carl Tyler; Adam T Perzynski; Alida M Gertz; Paulette Sage; Steven Lewis; Maurine Cobabe; Ying Ye; Michelle Menegay; Donna M Windish Journal: J Gen Intern Med Date: 2014-04-15 Impact factor: 5.128
Authors: John G Lawrenson; Ella Graham-Rowe; Fabiana Lorencatto; Jennifer Burr; Catey Bunce; Jillian J Francis; Patricia Aluko; Stephen Rice; Luke Vale; Tunde Peto; Justin Presseau; Noah Ivers; Jeremy M Grimshaw Journal: Cochrane Database Syst Rev Date: 2018-01-15