Use of Online Personalized Health Record System to Promote Self-Management of Diabetes (EMPOWER-D)
Recruitment status was Active, not recruiting
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Purpose
Diabetes is a major, growing, and costly chronic disease in the U.S., and implementation of recommended diabetes care remains poor, not merely suboptimal, and varied for a sizable proportion of Americans with diabetes. To further reduce the treatment and adherence gaps in diabetes care, the researchers propose to evaluate a Customized, Continuous Care Management (CCCM) program that actively supports a partnership between the patient and his/her multidisciplinary care management (CM) team using an online disease management (ODM) system, which is integrated with a comprehensive electronic health record (EHR) system that includes a personal health record and secure patient-clinician messaging capabilities. The CCCM program builds upon CM strategies proven effective in past studies and creates an ODM system that is built upon and fully integrated with a leading, commercially available EHR product - providing a blueprint for instituting customized, continuous care management for many different chronic conditions in a range of ambulatory care settings.
| Condition | Intervention |
|---|---|
|
Diabetes Mellitus |
Behavioral: Online disease management Other: Usual care - no intervention |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Investigator) Primary Purpose: Health Services Research |
| Official Title: | Patient-Centered Online Disease Management Using a Personal Health Record System |
- Hemoglobin A1C [ Time Frame: Baseline, 6 months and 12 months ] [ Designated as safety issue: No ]
- Self-management practices(e.g., medication adherence, home monitoring of glucose and BP, diet, and exercise) [ Time Frame: Baseline, 6 months and 12 months ] [ Designated as safety issue: No ]
- Processes of care (e.g., frequency of lab testing) [ Time Frame: Baseline, 6 months and 12 months ] [ Designated as safety issue: No ]
- Cardiovascular risk (e.g., blood pressure and lipids) [ Time Frame: Baseline, 6 months and 12 months ] [ Designated as safety issue: No ]
- Patient experience and satisfaction (e.g., relevant CAHPS measures) [ Time Frame: Baseline and 12 months ] [ Designated as safety issue: No ]
- Patient psychosocial well-being (e.g., diabetes-related emotional distress) [ Time Frame: Baseline, 6 months and 12 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 400 |
| Study Start Date: | March 2008 |
| Estimated Study Completion Date: | August 2011 |
| Primary Completion Date: | March 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Online disease management
The PAMFOnline-mediated Personalized Health Care Program, which couples a multidisciplinary diabetes care management team with an EHR-integrated Online Disease Management (ODM) system.
|
Behavioral: Online disease management
The Personalized Health Care Program couples a multidisciplinary care management team with an EHR-integrated Online Disease Management (ODM) system.
Other Name: EMPOWER-D
|
|
No Intervention: Usual care
Usual medical care. No access to the PHCP electronic system and self-management tools supporting this care management.
|
Other: Usual care - no intervention
Usual medical care. No access to the electronic system and self-management tools supporting this care management.
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- >= 18 years of age
- Have a designated Palo Alto Medical Foundation Primary Care Provider (PCP)
- Seen in primary or specialty care at the Palo Alto Division at least once in the preceding 24 months
- Diagnosis of diabetes
- Baseline A1C >= 7.5%
Exclusion Criteria:
- Initial diagnosis of diabetes within the last 12 months
- Diagnosis of Type 1 diabetes
- Inability to speak and read in English
- Lack of regular access to a computer with Internet and email capabilities
- Unwilling to perform any self-monitoring at home, including blood glucose and blood pressure%
- Pregnant, planning to become pregnant, or lactating
- Currently enrolled in a care management program at Palo Alto Medical Foundation or elsewhere
- PCP determination that the study is inappropriate or unsafe for the patient
- Investigator discretion for clinical safety or protocol adherence reasons
Contacts and Locations| United States, California | |
| PAMF Palo Alto Health Care Division | |
| Fremont, California, United States, 94538 | |
| PAMF Palo Alto Health Care Division | |
| Los Altos, California, United States, 94022 | |
| PAMF Camino Region | |
| Mountain View, California, United States, 94040 | |
| PAMF Palo Alto Health Care Division | |
| Palo Alto, California, United States, 94301 | |
| PAMF Palo Alto Health Care Division | |
| Redwood City, California, United States, 94063 | |
| PAMF Santa Cruz Medical Clinic | |
| Santa Cruz, California, United States, 95062 | |
| Principal Investigator: | Paul Tang, M.D. | Palo Alto Medical Foundation |
More Information
No publications provided by Palo Alto Medical Foundation
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Paul Tang, Vice President, Palo Alto Medical Foundation |
| ClinicalTrials.gov Identifier: | NCT00542204 History of Changes |
| Other Study ID Numbers: | 1 R18 HS017179-01 |
| Study First Received: | October 9, 2007 |
| Last Updated: | August 22, 2011 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Palo Alto Medical Foundation:
|
Diabetes Blood Glucose Self-Monitoring Home Blood Glucose Monitoring Internet Personal Health Record (PHR) Health Information Technology (HIT) Care management Disease Management |
Diabetes self-management Consumer Health Information Medical Records Systems, Computerized Computerized Medical Records System Automated Medical Records System Electronic Health Record (EHR) Remote patient monitoring |
Additional relevant MeSH terms:
|
Diabetes Mellitus Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |
ClinicalTrials.gov processed this record on June 17, 2013