20 Participants Needed

ECHO Program for Diabetes and Chronic Conditions

(E4DMMC Trial)

RG
JJ
Overseen ByJessica Jones, PhD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of New Mexico
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

Diabetes mellitus is a chronic condition that affects the body's ability to process sugar effectively, which over time can increase the risk of heart disease, high blood pressure, and kidney damage. Other chronic conditions include high cholesterol, obesity, and depression. Persons with diabetes mellitus and multiple chronic conditions (DMMC) face higher risks of losing physical or mental function, experiencing other chronic conditions, and death. Most of the residents of New Mexico (NM) belong to groups at risk for developing DMMC. Finding quality healthcare is a key factor, as NM also ranks among the largest, poorest, and most rural states. Primary care providers (PCPs) most often treat DMMC patients, but healthcare teams can lack confidence in managing these complex patients and struggle to keep up with recommended guidelines.This Project ECHO model (ECHO) for DMMC, a telehealth intervention for healthcare teams, can lead to lower blood sugar levels in DMMC patients being treated at NM primary care clinics. ECHO is a "telementoring" program that trains healthcare teams to provide specialized medical care at their local clinics. This is done by connecting healthcare teams with specialist mentors at academic medical centers through videoconferencing sessions. During ECHO program sessions, groups of healthcare teams hear lectures on key topics in DMMC care from experts, and then give presentations of anonymous patient cases by a healthcare teams for discussion and to receive recommendations.This clinical pragmatic trial aims to learn if the intervention will improve patient blood sugar levels in persons with DMMC who are being treated at selected health clinic sites throughout New Mexico.The study aims to answer:* Whether a 0.5% drop in HbA1c on average can be achieved in the group whose healthcare teams are receiving the ECHO intervention compared to the comparator group, whose providers will not receive the intervention.* Whether the rate of an individual's HbA1c was greater than 8.5% at the baseline will be reduced by 15% at the end of the intervention.Researchers will compare health data for patients empaneled to healthcare teams in the study and the usual care comparator group both before and after the intervention period to see whether the ECHO model has a positive influence on test results.

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.

Is the ECHO Program for Diabetes and Chronic Conditions safe for humans?

The safety of stress echocardiography, which may be related to the ECHO program, was evaluated in a study with 5,069 patients. The study found that using contrast for echocardiography was generally safe, with no significant increase in adverse events compared to noncontrast echocardiography.12345

How is the ECHO Program for Diabetes and Chronic Conditions treatment different from other treatments?

The ECHO Program is unique because it uses a telementoring model to connect primary care providers with specialists, helping them manage diabetes and chronic conditions more effectively, especially in underserved areas. This approach improves access to specialty care and enhances the knowledge and confidence of primary care providers, which can lead to better patient outcomes.678910

What data supports the effectiveness of the ECHO program for DMMC treatment for diabetes and chronic conditions?

Research shows that disease management programs for diabetes can improve quality of care and help patients manage their condition better. These programs have been associated with better control of blood sugar, cholesterol, and blood pressure, which are important for managing diabetes and related health issues.1112131415

Who Is on the Research Team?

SA

Sanjeev Arora, MD

Principal Investigator

University of New Mexico Health Science Center

YZ

Yiliang Zhu, PhD

Principal Investigator

University of New Mexico Health Science Center

VS

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?
2Treatment groups
Experimental Treatment
Active Control
Group I: ECHO InterventionExperimental Treatment1 Intervention
Group II: ComparatorActive Control1 Intervention

Find a Clinic Near You

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.
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

A disease management programme for patients with diabetes mellitus is associated with improved quality of care within existing budgets. [2022]
A systematic review of diabetes disease management programs. [2022]
Better lipid target achievement for secondary prevention through disease management programs for diabetes mellitus and coronary heart disease in clinical practice in Germany. [2018]
Evaluation of a diabetes specialist-guided primary care diabetes treatment program. [2022]
Outcomes management of an ambulatory clinic system population: experience with patients with diabetes. [2022]
Pragmatic clinic-based investigation of echocardiogram parameters in asymptomatic patients with type 2 diabetes in routine clinical practice and its association with suggestive coronary artery disease: a pilot study. [2023]
Model-based benefit-risk assessment: can Archimedes help? [2009]
A systematic review of event rates in clinical trials in diabetes mellitus: the importance of quantifying baseline cardiovascular disease history and proteinuria and implications for clinical trial design. [2018]
Safety of contrast administration for endocardial enhancement during stress echocardiography compared with noncontrast stress. [2016]
[Treatment of patients with type 2 diabetes mellitus: cardiovascular safety of incretin-based therapy supported by the ELIXA and TECOS trials]. [2016]
11.United Statespubmed.ncbi.nlm.nih.gov
Telementoring With Project ECHO: A New Era in Diabetes-Related Continuing Education for Primary Care to Address Health Disparities. [2023]
Democratizing type 1 diabetes specialty care in the primary care setting to reduce health disparities: project extension for community healthcare outcomes (ECHO) T1D. [2021]
Tele-education model for primary care providers to advance diabetes equity: Findings from Project ECHO Diabetes. [2023]
14.United Statespubmed.ncbi.nlm.nih.gov
A Telementoring Intervention Leads to Improvements in Self-Reported Measures of Health Care Access and Quality among Patients with Complex Diabetes. [2021]
15.United Statespubmed.ncbi.nlm.nih.gov
Tele-rounds and Case-Based Training: Project ECHO Telementoring Model Applied to Complex Diabetes Care. [2020]
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