NCT02122926已完成不适用
Effects of an Intensive Discharge Intervention on Medication Adherence, Glycemic Control, and Readmission Rates in Patients With Type 2 Diabetes
适应症
干预措施
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 180
- 试验地点
- 1
- 主要终点
- Cardiac medication adherence
研究概览
简要总结
The goal of this study is to design and implement an intensive discharge intervention for inpatients with type 2 diabetes and cardiovascular disease, and determine the effects of the intervention on post-discharge insulin adherence, glycemic control, cardiac medication adherence, hypoglycemic events, and emergency department visits and hospital readmissions.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult inpatients at BWH on the medicine or cardiology services with a primary care physician who belongs to a participating practice or has not explicitly opted out of the study
- •Type 2 diabetes
- •Active cardiovascular disease
- •Likely to be discharged home, and one of the following:
- •prescribed insulin prior to admission
- •prescribed two oral agents and with an A1c > 8.0 within 30 days of admission. - Practices that have already agreed to participate in this study for all their eligible patients.
排除标准
- •Discharge to a location other than home or rehabilitation (or to a caregiver's home)
- •Patient does not administer own medications and absence of a caregiver who lives with patient and administers all medications
- •Police custody, no telephone or homeless
- •Previous enrolment in the study within 90 days of discharge
- •Patient unable to communicate in either English or Spanish
- •Participation in the Integrated Care Management Program (iCMP)
研究组 & 干预措施
Intensive discharge intervention
Experimental
The intervention is a multi-modal program consisting of the following:
- Inpatient protocol for adjusting the discharge diabetes regimen;
- Nurse practitioner "discharge advocate" to schedule follow-up appointments, prepare an after-hospital care plan, and patient education and counseling;
- Inpatient pharmacist counseling (identifying and addressing previous barriers to medication adherence, performing enhanced medication reconciliation, and patient education);
- Visiting nurse intervention after discharge;
- Follow-up in a post-discharge clinic with the NP discharge advocate and pharmacist /certified diabetes educator within 3 days of discharge;
- Telemonitoring of POC glucose levels to the study CDE, patient's PCP, or endocrinologist as appropriate; and
- Follow-up with PCP or endocrinologist within 1 week of discharge.
干预措施: Intensive discharge intervention (Other)
Usual Care
No Intervention
Patients in the control arm of this study receive usual care.
结局指标
主要结局
Cardiac medication adherence
时间窗: 30 days after discharge
Cardiac medication adherence as determined by patient self report 30 days after discharge
次要结局
- Glycemic control(90 days after discharge)
- Emergency department visits(Within 30 days after discharge)
- Number of self-reported hypoglycemic events(Within 30 days of discharge)
- Number of patient-days with hypoglycemia(Within 30 days of discharge)
- Cardiac medication adherence(90 days after discharge)
- Hospital Readmissions(Within 30 days of discharge)
研究者
Jeffrey L. Schnipper, MD.,MPH.
Associate Professor of Medicine
Brigham and Women's Hospital
研究点 (1)
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