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Integrated Population Program for Diabetic Kidney Disease

Not Applicable
Completed
Conditions
Diabetic Kidney Disease
Uncontrolled Hypertension
Registration Number
NCT02418091
Lead Sponsor
Duke University
Brief Summary

This study will build a population management system Simultaneous risk factor control using Telehealth to slOw Progression of Diabetic Kidney Disease STOP-DKD Application STOP-DKD APP and conduct a 6-month controlled trial to compare reduction of blood pressure. In addition, the study will evaluate the feasibility of future large-scale intervention to slow diabetic kidney disease (DKD) DKD progression.

Aim 1: Identify patients with moderate DKD and uncontrolled hypertension (HTN) using existing electronic health record data in an integrated data warehouse (Southeastern Diabetes Initiative- SEDI) to screen all patients within SEDI.

Aim 2: Implement an intervention designed to slow progression of DKD and treat associated conditions in a high-risk population with moderate DKD and uncontrolled HTN using the STOP-DKD APP

* Primary Outcome: Test the hypothesis that patients who receive the intervention will have greater improvements in blood pressure as compared to a control group after 6 months

* Secondary Outcomes: Exploratory analyses to determine whether patients who receive the intervention will have less progression (defined as a smaller decrease in kidney function), and improved behaviors that affect HTN control and cardiovascular risk (medication adherence, diet, physical activity, and weight control) as compared to a control group after 6 months

Aim 3: Evaluate the STOP-DKD APP Study to guide large-scale implementation \& dissemination

* Impact Evaluation: Assess the potential population impact of our intervention using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework

* Economic Evaluation: Conduct an economic evaluation using the Archimedes Model by estimating projected costs and quality-adjusted life-years

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
131
Inclusion Criteria

Not provided

Exclusion Criteria

Patients who meet any one of the exclusion criteria will be excluded:

  • No access to telephone
  • Not proficient in English
  • Nursing home/long-term care facility resident or receiving home health care
  • Impaired hearing/ speech/ vision
  • Participating in another trial (pharmaceutical or behavioral)
  • Planning to leave the area in the next 3 years
  • Pancreatic insufficiency or diabetes secondary to pancreatitis
  • Alcohol abuse (>14 alcoholic beverages/ wk)
  • Diagnosis of non-diabetic kidney disease
  • Active malignancy (other than non-melanomatous skin cancer)
  • Diagnosis of life-threatening disease with death probable within 4 years.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
Change in Blood PressureBaseline & 6months
Secondary Outcome Measures
NameTimeMethod
Change in dietary habits as measured by questionnaireBaseline & 6month
Change in taking medicine as prescribedBaseline& 6month

Investigators will assess whether patients who receive the intervention will have improved behaviors that affect HTN control and cardiovascular risk (medication adherence) as compared to a control group after 6 months

Change in estimated Glomerular filtration rate (eGFR) for kidney functionBaseline & 6months
Change in weightBaseline & 6month
Change in amount of physical activity as measured by questionnaireBaseline & 6month

Investigators will assess whether patients who receive the intervention will have improved behaviors that affect HTN control and cardiovascular risk ( physical activity) as compared to a control group after 6 months

Trial Locations

Locations (1)

Duke Clinical Research Institute

🇺🇸

Durham, North Carolina, United States

Duke Clinical Research Institute
🇺🇸Durham, North Carolina, United States

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