Diabetes Mellitus, Type 1 Clinical Trial
Official title:
Diabetes Telemedicine Consultation: A Systems Improvement Intervention
This study seeks to evaluate and document the processes of outreach consultation through joint-clinics via teleconferencing as an intervention for system improvement in care delivery and management of diabetes mellitus (DM) at a Community Based Outpatient Center (CBOCs).
Background:
Diabetes is a national problem that has reached epidemic proportions, according to the U.S.
Centers for Disease Control and Prevention. Diabetes has particular importance for the
Department of Veterans Affairs (VA) because the prevalence among VA patients -- one in six,
or 16 percent -- is substantially higher than in the general population.
Objectives:
The objective of this study was to evaluate and document the processes of outreach
consultation through the use of joint-clinics via teleconferencing as an intervention for
system improvement in care delivery and management of diabetes at CBOCs. The intervention
consisted of a teleconferenced joint-clinic consultation session involving the patient,
Diabetes Specialist Team, the Primary Care Provider (PCP) and other relevant care team
members. The impact of the 16-month intervention was assessed based on patients who were
involved in the telemedicine clinic and those who were referred to a specialist to be seen
on-site at the Cleveland VAMC.
Methods:
Study settings include the CBOCs affiliated with the Cleveland Veterans Affairs Medical
Center (VAMC) and involve primary care referrals to see diabetes specialists at the
Cleveland VAMC. Inclusion criteria patients(N 282)=included: (i) current prescription of
insulin or an oral hypoglycemic agent; (ii) A1c > 7.0%; or (iii) fasting glucose levels> 130
mg/dl; and (iv) referred to see a consultant (beginning three months prior to the active
intervention phase and continuing through enrollment for the last month of the active
intervention phase). Patients with either Type l or Type II diabetes will be included.
Patients referred will be contacted and asked to participate.
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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