Provider-Initiated Regular Remote Interventions for Optimal Type 2 Diabetes Care
| Status: | Completed |
|---|---|
| Conditions: | Diabetes, Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/4/2018 |
| Start Date: | August 2013 |
| End Date: | June 2017 |
Patients with type 2 diabetes can attain superior disease outcomes if multiple therapy goals
are simultaneously achieved and maintained. In reality, therapy goals are seldom achieved,
and patients become susceptible to devastating complications and greater health care
expenses. Studies have shown that regular monitoring and therapy adjustments are a
prerequisite to achieving and maintaining therapy goals. Unfortunately implementation of
regular monitoring and therapy adjustments have been hindered by high clinic workload and
shortage of endocrinologists. Due to this shortage, endocrine care is accessible to less than
20% of patients with type 2 diabetes. The overwhelming majority are managed by providers who
may lack the necessary expertise or time to deliver optimal disease management, particularly
when insulin is prescribed.
Objectives: We hypothesize that type 2 diabetes endocrine clinics for high-risk patients that
complement primary care, personalize the frequency of remote disease interventions and employ
infrequent face-to-face outpatient visits, will achieve comparable clinical outcomes and
patient satisfaction compared to usual endocrine clinic care, while reducing workload and
increasing the clinic capacity. The intervention clinic will employ regular remote
communications initiated by the endocrinologists, based on tailored individual plans.
Frequent remote monitoring and interventions will reinforce attainment of the therapy goals
and allow a decrease in the frequency of outpatient visits. In turn, the clinic workload will
decrease and it will be able to accommodate more patients with type 2 diabetes than
traditional endocrine clinics. The aims of the study are to test this new endocrine clinic
model in a clinical trial by monitoring clinical parameters, patient satisfaction and
clinical workload. The long-term objectives are to modify the current model of endocrine care
for patients with type 2 diabetes.
are simultaneously achieved and maintained. In reality, therapy goals are seldom achieved,
and patients become susceptible to devastating complications and greater health care
expenses. Studies have shown that regular monitoring and therapy adjustments are a
prerequisite to achieving and maintaining therapy goals. Unfortunately implementation of
regular monitoring and therapy adjustments have been hindered by high clinic workload and
shortage of endocrinologists. Due to this shortage, endocrine care is accessible to less than
20% of patients with type 2 diabetes. The overwhelming majority are managed by providers who
may lack the necessary expertise or time to deliver optimal disease management, particularly
when insulin is prescribed.
Objectives: We hypothesize that type 2 diabetes endocrine clinics for high-risk patients that
complement primary care, personalize the frequency of remote disease interventions and employ
infrequent face-to-face outpatient visits, will achieve comparable clinical outcomes and
patient satisfaction compared to usual endocrine clinic care, while reducing workload and
increasing the clinic capacity. The intervention clinic will employ regular remote
communications initiated by the endocrinologists, based on tailored individual plans.
Frequent remote monitoring and interventions will reinforce attainment of the therapy goals
and allow a decrease in the frequency of outpatient visits. In turn, the clinic workload will
decrease and it will be able to accommodate more patients with type 2 diabetes than
traditional endocrine clinics. The aims of the study are to test this new endocrine clinic
model in a clinical trial by monitoring clinical parameters, patient satisfaction and
clinical workload. The long-term objectives are to modify the current model of endocrine care
for patients with type 2 diabetes.
Emerging data suggests that clinical interventions may be implemented successfully by a
variety of remote communications. Thus far regular monitoring and treatment adjustments by
remote communications have not yet been fully integrated into endocrine practice in a
scalable fashion that can be readily disseminated. The PI proposes to test a new endocrine
model care clinic for high-risk patients with type 2 diabetes that employs regular
communications initiated by the provider, based on a tailored individual plan. Frequent
monitoring and interventions will reinforce attainment of prespecified therapy goals, enhance
patient engagement, and allow a significant decrease in the frequency of outpatient visits.
In turn, the clinic will be able to accommodate more patients with type 2 diabetes than
traditional endocrine clinics. Data management and day-to-day clinic operation will be
computerized with technology that has been developed by the institution. The project is
highly significant since it proposes a new model of endocrine care for high-risk patients
with type 2 diabetes that may improved disease outcome in more patients and reduce medical
expenses.
variety of remote communications. Thus far regular monitoring and treatment adjustments by
remote communications have not yet been fully integrated into endocrine practice in a
scalable fashion that can be readily disseminated. The PI proposes to test a new endocrine
model care clinic for high-risk patients with type 2 diabetes that employs regular
communications initiated by the provider, based on a tailored individual plan. Frequent
monitoring and interventions will reinforce attainment of prespecified therapy goals, enhance
patient engagement, and allow a significant decrease in the frequency of outpatient visits.
In turn, the clinic will be able to accommodate more patients with type 2 diabetes than
traditional endocrine clinics. Data management and day-to-day clinic operation will be
computerized with technology that has been developed by the institution. The project is
highly significant since it proposes a new model of endocrine care for high-risk patients
with type 2 diabetes that may improved disease outcome in more patients and reduce medical
expenses.
Inclusion Criteria:
- Men or women aged ≥18 years of age;
- Clinical diagnosis of type 2 diabetes (as defined by the American Diabetes Association
2);
- Treated with insulin or at least two diabetes medications;
- Have A1C ≥8.0% and ≤11.0%;
- Able and willing to use telephone or other sorts of communication regularly between
clinic visits.
Exclusion Criteria:
- Do not speak English;
- Unwilling or unable to provide informed consent;
- Have any condition associated with life expectancy of less than 3 years;
- Have an active mental illness or substance abuse
We found this trial at
1
site
1500 E Medical Center Dr
Ann Arbor, Michigan 48109
Ann Arbor, Michigan 48109
(734) 936-4000
University of Michigan Health System The University of Michigan is home to one of the...
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