Managing the Space between Visits: A Randomized Trial of Disease Management for Diabetes in a Community Health Center
Open accessAbstract
Background Diabetes outcomes are worse for underserved patients from certain ethnic/racial minority populations. Telephonic disease management is a cost-effective strategy to deliver self-management services and possibly improve diabetes outcomes for such patients.Objective We conducted a trial to test the effectiveness of a supplemental telephonic disease management program compared to usual care alone for patients with diabetes cared for in a community health center.Design Randomized controlled trial.Participants All patients had type 2 diabetes, and the majority was Hispanic or African American. Most were urban-dwelling with low socioeconomic status, and nearly all had Medicaid or were uninsured.Measurements Clinical measures included glycemic control, blood pressure, lipid levels, and body mass index. Validated surveys were used to measure dietary habits and physical activity.Results A total of 146 patients were randomized to the intervention and 149 to the control group. Depressive symptoms were highly prevalent in both groups. Using an intention to treat analysis, there were no significant differences in the primary outcome (HbA1c) between the intervention and control groups at 12 months. There were also no significant differences for secondary clinical or behavioral outcome measures including BMI, systolic or diastolic blood pressure, LDL cholesterol, smoking, or intake of fruits and vegetables, or physical activity.Conclusions A clinic-based telephonic disease management support for underserved patients with diabetes did not improve clinical or behavioral outcomes at 1 year as compared to patients receiving usual care alone.
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In two studies reporting depression, there were no group differences.
“Two studies reported on depression.14 16 There were no group differences found in these two studies.”
From Effectiveness of synchronous teleconsultation for patients with type 2 diabetes mellitus: a systematic review and meta-analysis (2023) · cites this paper as [14]
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- Authors
- Anderson, D. R., Christison-Lagay, J., Villagra, V., Liu, H., & Dziura, J.
- Affiliations
- Yale University (US)
- Community Health Center (US)
- University of Connecticut (US)
- Corresponding author
- Anderson, Daren R.
- ORCID
- Anderson, Daren R.
- Venue
- Journal of General Internal Medicine
- Published
- 2010-06-16
- Volume
- 25
- Issue
- 10
- Pages
- 1116-1122
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC2955486
- OpenAlex
- W2094178440
- Cited by
- 64
- References
- 29
- Citations by year
- 2025: 3 · 2024: 6 · 2023: 6 · 2022: 4 · 2021: 3 · 2019: 2 · 2018: 7 · 2017: 5 · 2016: 7 · 2015: 7 · 2014: 8 · 2013: 4 · 2012: 2
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Connecticut Health Foundation
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- diabetes management, type 2 diabetes, underserved populations, Hispanic patients, African American patients, community health centers, glycemic control, HbA1c, self-management support, depressive symptoms, low socioeconomic status, Medicaid, uninsured patients, physical activity, dietary habits
- MeSH terms
- Community Health Centers, Diabetes Mellitus, Type 2, Female, Humans, Male, Office Visits, Socioeconomic Factors, Treatment Outcome, Telemedicine, Disease Management
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