Telementoring for Diabetes Care Improvement

Recruiting at 1 trial location

Overseen By Elizabeth M. Vaughan

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas Medical Branch, Galveston

Must be taking: Oral anti-hyperglycemics

Disqualifiers: Pregnancy, Severe cognitive impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

320 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

Diabetes care is complex and requires a multidimensional approach, but interventional programs are difficult to initiate in low-income and minority populations. In the proposed study, investigators will mentor local clinics via telehealth to initiate our diabetes program involving telehealth-support, integrated CHWs, medication-access, and diabetes Education into their clinics. Mentoring local clinics to initiate this intervention is a promising strategy to enhance sustainable diabetes care and reduce disparities in vulnerable minority populations.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems likely that you can continue your current diabetes medications, as the trial involves mentoring clinics to improve diabetes care.

Is telementoring generally safe for humans?

Telementoring has been used safely in various settings, including diabetes care and surgical training, showing promise in safely adopting new procedures and improving care quality. ^{1 2 3 4 5}

How is the telementoring treatment for diabetes care unique?

Telementoring for diabetes care is unique because it uses the Project ECHO model to connect primary care providers with specialists, allowing them to gain expertise in managing complex diabetes cases. This approach helps improve care in underserved areas by sharing specialist knowledge with multiple providers, unlike traditional telemedicine that typically connects one patient with a specialist. ^{1 3 5 6 7}

What data supports the effectiveness of the treatment Telementoring for diabetes care improvement?

Research shows that the telementoring model, like Project ECHO, helps improve diabetes management in underserved communities by enhancing the knowledge and skills of healthcare providers. This approach has been effective in managing complex diabetes cases and improving health outcomes, especially in areas with limited access to specialists. ^{1 3 5 6 7}

Who Is on the Research Team?

Elizabeth Vaughan, DO

Principal Investigator

UTMB

Are You a Good Fit for This Trial?

This trial is for Spanish-speaking adults over 18 with type 2 diabetes, an HbA1c level of at least 6.5%, and taking oral diabetes medication. Participants must be uninsured, below the poverty line, and self-identify as Latino(a). It's not for those who miss group visits, have conditions affecting HbA1c levels or need frequent clinic visits.

Inclusion Criteria

I have type 2 diabetes with an HbA1c level of 6.5% or higher and am taking oral medication for it.

I speak Spanish.

Uninsured and below 150% of the federal poverty level

Exclusion Criteria

No show to all group visits

You are not able to receive care in a group setting, such as if you are pregnant or have severe memory or thinking problems.

You have a condition that may change your HbA1c levels, like having had a recent blood transfusion.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive a 12-month diabetes program involving telehealth support, integrated CHWs, medication access, and diabetes education

12 months

Monthly individual appointments with pharm-Ds or nutritionists

Follow-up

Participants are monitored for clinical changes including HbA1c, blood pressure, cholesterol, and BMI

24 months

What Are the Treatments Tested in This Trial?

Interventions

• Telementoring

Trial Overview The study tests a telementoring program called TIME that helps local clinics start a comprehensive diabetes care initiative. The focus is on integrating community health workers (CHWs), improving medication access, and providing group education through telehealth support.

How Is the Trial Designed?

Group I: Usual Care (UC) Experimental Treatment 1 Intervention

We will define UC as usual clinical care, which consists of diabetes management provider encounters (mean quarterly) plus monthly individual appointments with a pharm-Ds or nutritionists as clinically indicated. In addition, clinics offer multiple other individual and group opportunities.

Group II: Intervention Experimental Treatment 1 Intervention

Intervention individuals will receive the 12-month diabetes program

Who Is Running the Clinical Trial?

The University of Texas Medical Branch, Galveston

Lead Sponsor

Trials

263

Recruited

55,400+

Baylor College of Medicine

Collaborator

Trials

1,044

Recruited

6,031,000+

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Collaborator

Trials

2,513

Recruited

4,366,000+

University of Texas

Collaborator

Trials

193

Recruited

143,000+

The University of Texas Health Science Center, Houston

Collaborator

Trials

974

Recruited

361,000+

University of Houston

Collaborator

Trials

155

Recruited

48,600+

Published Research Related to This Trial

Project ECHO is a telementoring program that enhances the management of complex diseases like diabetes in underserved areas by allowing multiple patients to benefit from shared expertise, rather than just one-on-one specialist consultations.

The Endo ECHO program, specifically designed for patients with complex diabetes in rural New Mexico, is undergoing a 4-year evaluation to assess its impact on health outcomes, healthcare utilization, and cost-effectiveness, potentially serving as a model for similar initiatives globally.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Taking Telemedicine to the Next Level in Diabetes Population Management: a Review of the Endo ECHO Model. Bouchonville, MF., Paul, MM., Billings, J., et al.[2018]

Citations

1. Netherlands pubmed.ncbi.nlm.nih.gov

Multisite Quality Improvement Program Within the Project ECHO Diabetes Remote Network. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Comparison of Care Provided to Underserved Patients With Diabetes by a Telementoring Model of Care to Care Provided by a Specialty Clinic: Endo ECHO Versus an Academic Specialty Clinic. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Effectiveness of Telementoring in Improving Provider Knowledge, Attitudes, and Perceived Competence in Managing Chronic Pain: A Mixed Methods Study. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Taking Telemedicine to the Next Level in Diabetes Population Management: a Review of the Endo ECHO Model. [2018]

5. United States pubmed.ncbi.nlm.nih.gov

Tele-rounds and Case-Based Training: Project ECHO Telementoring Model Applied to Complex Diabetes Care. [2020]

6. Germany pubmed.ncbi.nlm.nih.gov

Project 6 Summit: SAGES telementoring initiative. [2018]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Commercial videoconferencing for use in telementoring laparoscopic surgery. [2017]