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EXpanding Technology-Enabled, Nurse-Delivered Chronic Disease Care (EXTEND): Protocol and Baseline Data for a Randomized Trial.
German, Jashalynn; Yang, Qing; Hatch, Daniel; Lewinski, Allison; Bosworth, Hayden B; Kaufman, Brystana G; Chatterjee, Ranee; Pennington, Gina; Matters, Doreen; Lee, Donghwan; Urlichich, Diana; Kokosa, Sarah; Canupp, Holly; Gregory, Patrick; Roberson, Cindy Leslie; Smith, Benjamin; Huber, Sherry; Doukellis, Katheryn; Deal, Tammi; Burns, Rose; Crowley, Matthew J; Shaw, Ryan J.
Afiliación
  • German J; Division of Endocrinology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
  • Yang Q; School of Nursing, Duke University, Durham, NC, USA.
  • Hatch D; School of Nursing, Duke University, Durham, NC, USA.
  • Lewinski A; School of Nursing, Duke University, Durham, NC, USA; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, United States of America.
  • Bosworth HB; Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
  • Kaufman BG; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, United States of America; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Duke-Margolis Center for Health Policy, Duke U
  • Chatterjee R; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC 27713, USA.
  • Pennington G; School of Nursing, Duke University, Durham, NC, USA.
  • Matters D; School of Nursing, Duke University, Durham, NC, USA.
  • Lee D; School of Nursing, Duke University, Durham, NC, USA.
  • Urlichich D; School of Nursing, Duke University, Durham, NC, USA.
  • Kokosa S; Department of Pharmacy, Duke University, Durham, NC, USA.
  • Canupp H; Department of Pharmacy, Duke University, Durham, NC, USA.
  • Gregory P; Department of Pharmacy, Duke University, Durham, NC, USA.
  • Roberson CL; Department of Pharmacy, Duke University, Durham, NC, USA.
  • Smith B; Department of Pharmacy, Duke University, Durham, NC, USA.
  • Huber S; Duke Office of Clinical Research, Duke University School of Medicine, Durham, NC, USA.
  • Doukellis K; Duke Office of Clinical Research, Duke University School of Medicine, Durham, NC, USA.
  • Deal T; Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC 27713, USA.
  • Burns R; Duke Office of Clinical Research, Duke University School of Medicine, Durham, NC, USA.
  • Crowley MJ; Division of Endocrinology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, United States of America.
  • Shaw RJ; School of Nursing, Duke University, Durham, NC, USA. Electronic address: ryan.shaw@duke.edu.
Contemp Clin Trials ; 146: 107673, 2024 Aug 30.
Article en En | MEDLINE | ID: mdl-39216685
ABSTRACT

BACKGROUND:

Approximately 10-15 % of individuals with type 2 diabetes have persistently poorly-controlled diabetes mellitus (PPDM) despite receiving available care, and frequently have comorbid hypertension. Mobile monitoring-enabled telehealth has the potential to improve outcomes in treatment-resistant chronic disease by supporting self-management and facilitating patient-clinician contact but must be designed in a manner amenable to real-world use.

METHODS:

Expanding Technology-Enabled, Nurse-Delivered Chronic Disease Care (EXTEND) is an ongoing randomized trial comparing two 12-month interventions for comorbid PPDM and hypertension 1) EXTEND, a mobile monitoring-enabled self-management intervention; and 2) EXTEND Plus, a comprehensive, nurse-delivered telehealth program incorporating mobile monitoring, self-management support, and pharmacist-supported medication management. Both arms leverage a novel platform that uses existing technological infrastructure to enable transmission of patient-generated health data into the electronic health record. The primary study outcome is difference in HbA1c change from baseline to 12 months. Secondary outcomes include blood pressure, weight, implementation barriers/facilitators, and costs.

RESULTS:

Enrollment concluded in June 2023 following randomization of 220 patients. Baseline characteristics are similar between arms; mean age is 54.5 years, and the cohort is predominantly female (63.6 %) and Black (68.2 %), with a baseline HbA1c of 9.81 %.

CONCLUSION:

The EXTEND trial is evaluating two mobile monitoring-enabled telehealth approaches that seek to improve outcomes for patients with PPDM and hypertension. Critically, these approaches are designed around existing infrastructure, so may be amenable to implementation and scaling. This study will promote real-world use of telehealth to maximize benefits for those with high-risk chronic disease.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Contemp Clin Trials Asunto de la revista: MEDICINA / TERAPEUTICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Contemp Clin Trials Asunto de la revista: MEDICINA / TERAPEUTICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos