TACTICS (Targeting Adherence to Cholesterol-lowering Therapy to Improve Control Study)

NCT ID: NCT01043354

Last Updated: 2014-04-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

247 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-09-30

Study Completion Date

2012-06-30

Brief Summary

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Background:

This is a randomized controlled trial (RCT) of two novel behavioral interventions to enhance treatment adherence and improve low-density lipoprotein cholesterol (LDL) in diabetes. Among adults with diabetes, high LDL greatly increases their risk for cardiovascular disease (CVD). Despite the proven efficacy of LDL control(\<100 mg/dL) in preventing CVD, the control rate is low. Poor adherence to treatment(diet, exercise and medication) is the main reason for this poor control.

Aims: This study will test two telephone-delivered interventions, a Transtheoretical stage-matched intervention (SMI) and a Prospect theory-based framing effects intervention (FEI). The investigators hypothesize that both SMI and FEI will be more effective in improving LDL control than an attention placebo intervention (API) at 6 months. SMI and FEI will also be more effective in increasing adherence to medications, diet and exercise than API at 6 months.

Methods:

The investigators will recruit 246 adults with diabetes and high LDL despite being on medications. Key outcomes are adherence to diet, exercise and medication, and LDL control. The interventions will be standardized and fidelity of intervention maintained. Using a blinded RCT the investigators will test the effect of SMI and FEI compared to API on LDL control and adherence. All analyses will be intent to treat.

Significance:

This project will provide important information to improve diabetes-related behavior and lead to the implementation of novel interventions for lowering LDL in primary care settings among adults with diabetes. It may also provide the scientific rationale to use such approaches to control other risk factors in diabetes.

Detailed Description

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Conditions

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Hypercholesterolemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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stage-matched intervention

Transtheoretical Model-based stage-matched intervention

Group Type EXPERIMENTAL

stage-matched intervention

Intervention Type BEHAVIORAL

6 monthly tailored telephone-delivered counseling sessions of transtheoretical model-based counseling

framing effects intervention

counseling based on prospect theory

Group Type EXPERIMENTAL

framing effects intervention

Intervention Type BEHAVIORAL

6 monthly telephone-delivered counseling sessions based on prospect theory

attention placebo intervention

counseling about general health topics

Group Type ACTIVE_COMPARATOR

attention placebo intervention

Intervention Type BEHAVIORAL

6 monthly counseling sessions about general health topics

Interventions

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stage-matched intervention

6 monthly tailored telephone-delivered counseling sessions of transtheoretical model-based counseling

Intervention Type BEHAVIORAL

framing effects intervention

6 monthly telephone-delivered counseling sessions based on prospect theory

Intervention Type BEHAVIORAL

attention placebo intervention

6 monthly counseling sessions about general health topics

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Adults with diabetes
* LDL greater than or equal to 100
* Cholesterol-lowering drug therapy for \> 6 months
* A working telephone
* At least 2 primary care visits in the past 1.5 years

Exclusion Criteria

* Poor short-term survival (\< 1 year)
* Inability to understand English
* Recent major surgery (\< 3 months)
* Patients temporarily in the area
* Inability to provide consent
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Narrows Institute for Biomedical Research

OTHER

Sponsor Role lead

Responsible Party

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Sundar Natarajan

Attending Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sundar Natarajan, MD, M.Sc.

Role: PRINCIPAL_INVESTIGATOR

VA New York Harbor Healthcare System

Locations

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VA New York Harbor Healthcare System, NY and BK Campuses

New York, New York, United States

Site Status

Countries

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United States

Other Identifiers

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ADA 7-08-CR-68

Identifier Type: -

Identifier Source: org_study_id

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