ECHO Program for Diabetes and Chronic Conditions

(E4DMMC Trial)

Overseen By Jessica Jones, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of New Mexico

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

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method to assist people with diabetes and other chronic conditions through the ECHO program, which connects local healthcare teams with expert mentors via online sessions. The goal is to determine if this program can lower blood sugar levels for patients at specific clinics in New Mexico. Patients with diabetes and other ongoing health issues receiving care at participating clinics might be suitable candidates. Researchers will compare results from clinics using the ECHO program to those continuing with regular care to assess any significant improvement in diabetes management. As an unphased trial, this study allows patients to contribute to innovative healthcare solutions that could enhance diabetes management.

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 to focus on training healthcare teams rather than changing patient medications.

What prior data suggests that this ECHO program is safe for healthcare teams?

Research has shown that the ECHO program, a telehealth service, safely manages diabetes and other long-term health issues. Studies have found that this program aids healthcare teams by connecting them with specialist mentors through video calls. These calls enhance the teams' knowledge and confidence in treating complex conditions, which is crucial for patient care.

The Project ECHO model has been used successfully before, particularly for managing diabetes, and has enabled primary care providers to deliver better care without causing harm. No reports of negative effects or safety problems have been linked to this type of program. Since this program does not involve direct medical procedures or new medications for patients, it presents much lower safety concerns compared to other medical treatments. ^{1 2 3 4 5}

Why are researchers excited about this trial?

The ECHO program for managing diabetes and other chronic conditions is unique because it focuses on enhancing the skills and collaboration of healthcare teams rather than introducing a new medication or procedure. Unlike standard treatments that typically involve medication management and lifestyle changes, the ECHO program emphasizes education and mentorship for healthcare providers, which can lead to more personalized and effective patient care. Researchers are excited about this trial because it has the potential to improve health outcomes by empowering healthcare teams to deliver better, more coordinated care, ultimately benefiting patients with diabetes and chronic conditions.

What evidence suggests that the ECHO program is effective for diabetes and chronic conditions?

Research has shown that the ECHO program can enhance diabetes care. In this trial, the ECHO Intervention Arm involves healthcare teams participating in the ECHO program, which uses telehealth to connect local healthcare teams with specialist mentors. Patients whose primary care doctors participate in this intervention have experienced better access to healthcare and improved self-care habits. Studies have found that these telehealth sessions lead to better care for patients with diabetes and other chronic conditions. The program helps healthcare teams manage complex cases more effectively, resulting in better health outcomes, such as lower blood sugar levels. Meanwhile, the Comparator Arm will continue with usual care practices. ^{1 2 4 6 7}

Who Is on the Research Team?

Matthew Bouchonville, MD

Principal Investigator

University of New Mexico Health Science Center

Yiliang Zhu, PhD

Principal Investigator

University of New Mexico Health Science Center

Vallabh Shah, PhD

Principal Investigator

University of New Mexico Health Science Center

Are You a Good Fit for This Trial?

This trial is for people with diabetes and other chronic conditions in New Mexico. It's designed to help those treated by primary care providers who may need more support managing complex health issues. To join, participants must be receiving treatment at selected NM clinics.

Inclusion Criteria

I am a healthcare team member aged 18-89, of any gender and ethnicity.

Twenty PMS sites with the highest patient volume

Exclusion Criteria

There is no exclusion criteria.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Healthcare teams participate in weekly ECHO program videoconference sessions for telementoring on complex care strategies for DMMC patients.

18 months

Weekly videoconference sessions

Comparator

Usual care practices continue at clinical sites without the ECHO intervention.

18 months

Follow-up

Participants are monitored for safety and effectiveness after the intervention period.

18 months

What Are the Treatments Tested in This Trial?

Interventions

• ECHO program for DMMC

Trial Overview The study tests the ECHO program, a telehealth intervention that trains healthcare teams through videoconferencing with specialists. The goal is to see if this training can lower blood sugar levels in patients compared to usual care without the ECHO program.

How Is the Trial Designed?

Group I: ECHO Intervention Experimental Treatment 1 Intervention

10 FQHCs from the PMS health system will be randomized to the ECHO Intervention Arm. All healthcare team members in the intervention arm will attend ECHO program sessions, and the FQHCs are the primary subjects of the ECHO intervention. However, the investigators examine outcomes at both the level of the healthcare team and at the level of the patients who are empaneled to the healthcare team. Persons with DMMC cared for by the healthcare teams at the FQHC clinics are the patient population for this intervention.

Group II: Comparator Active Control 1 Intervention

10 FQHCs from the PMS health system will be randomized to the comparator arm which is usual care. Persons with DMMC cared for by the healthcare teams at the FQHC clinics are the patient population for this comparator arm.

Who Is Running the Clinical Trial?

University of New Mexico

Lead Sponsor

Trials

393

Recruited

3,526,000+

Patient-Centered Outcomes Research Institute

Collaborator

Trials

592

Recruited

27,110,000+

Presbyterian Medical Services

Collaborator

Trials

1

Recruited

20+

Published Research Related to This Trial

The ECHO T1D program successfully improved the diabetes knowledge and confidence of 70 primary care providers (PCPs) in managing type 1 diabetes (T1D) through 27 tele-education clinics over a 6-month period, demonstrating its effectiveness in enhancing care in underserved areas.

The program reached over 2000 patients with T1D across 23 clinics in Florida and California, showcasing its potential as a sustainable model for providing specialty support to PCPs in communities with limited access to endocrinologists.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Democratizing type 1 diabetes specialty care in the primary care setting to reduce health disparities: project extension for community healthcare outcomes (ECHO) T1D. Walker, AF., Cuttriss, N., Haller, MJ., et al.[2021]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06451458

ECHO for Diabetes and Multiple Chronic Conditions Study The ECHO for Diabetes and Multiple Chronic Conditions (E4DMMC) study is a cluster-randomized pragmatic trial, and will investigate the effectiveness of Project ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11576679/

Clinical Outcomes of Rural Patients with Diabetes Treated by ... Patients receiving care from ECHO-trained PCPs reported improvements in access and quality of diabetes care, self-care behaviors, and quality ...

3. nminbre.org nminbre.org/project-echo-launches-study-on-improving-outcomes-for-diabetic-patients-with-chronic-conditions/

Project ECHO Launches Study on Improving Outcomes for ... The study will assess the effectiveness of the ECHO Model, a telehealth-based mentoring program, in improving patient outcomes.

4. pcori.org pcori.org/research-results/2023/comparing-telehealth-and-usual-care-diabetes-management-patients-multiple-chronic-conditions

Comparing Telehealth and Usual Care for Diabetes ... This study compares usual care with a telehealth program called Project ECHO for adults with diabetes and multiple chronic conditions (DMMC) ...

5. withpower.com withpower.com/trial/phase-diabetes-mellitus-9-2024-13e7e

ECHO Program for Diabetes and Chronic Conditions ... The ECHO T1D program successfully improved the diabetes knowledge and confidence of 70 primary care providers (PCPs) in managing type 1 diabetes (T1D) through ...

6. echodiabetes.org echodiabetes.org/outcomes

Outcomes The Project ECHO Model is a proven tele-mentoring model that is designed to explicitly target PCPs, address health disparities, and improve patient outcomes.

7. projectecho.unm.edu projectecho.unm.edu/news/project-echo-diabetes-study-patients-with-chronic-conditions/

Diabetes - Project ECHO - The University of New Mexico Project ECHO Launches Study on Improving Outcomes for Diabetic Patients with Chronic Conditions. Date: 01 Apr 2024. Read Time: 5 minutes. Topic: Diabetes.