CDRM Study: Computer-assisted Diabetes Risk Management-for Secondary and Tertiary Prevention of T2DM Complications

NCT ID: NCT01556529

Last Updated: 2012-03-21

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

405 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-06-30

Study Completion Date

2011-06-30

Brief Summary

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The CDRM study will evaluate a newly developed approach to improve management and secondary prevention in diabetes care. The research will explore the impact of an medical care intervention via a computer-assisted diabetes risk management system (CDRMS) on compliance and outcome The focus will be on the effect on patients' diabetes and diabetes complication risk profiles, medical effectiveness and patients- reported outcomes.

Detailed Description

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The study will determine the effects of a computer-assisted diabetes risk management (CDRM) system on compliance and outcome. All subjects are Type 2 Diabetes Mellitus (T2DM) patients enrolled in the National T2DM Disease Management Programme (DMP) offered by the German National Health Insurance System. Of all people living in Germany 90% are insured there; more than 60% of all T2DM patients insured there are - voluntarily - enrolled in the T2DM-DMP. As in any DMP, the rationale is that by regular visits to the attending physician, strict application of National Guidelines and by keeping the patient in a narrow corridor of optimal biomedical parameters (SBP, DBP, BMI, and specific lab parameters), the probability of complications, hospitalizations and other functional impairments is minimized.

The rationale of the study is that more information on individual risk profile and its changes in the course of care will lead to more patient empowerment adding to more effective preventing the manifestation of these risks.

The Intervention Group, in addition to receiving the T2DM care standard according to the National Guidelines issued by AWMF, within the framework of the National T2DM Disease Management Programme, will receive individualized reports showing their personal risk for the characteristic T2DM complications. Reports are sent to attending general practitioners (GP) for communicating and explaining them to patients.

The CDRM system entails a combination of several telematic instruments used by the patient, GP and medical specialists. Key functionalities of the network supporting the care approach are the software integration of GP practices and an automated data recording via digital devices of blood glucose meters. Furthermore, the CDRM-Tool, Accu-Chek Mellibase a client server application of Roche Diagnostics GmbH is connected to the system.

It generates reports - one for the physician and one for the patient - on the current health status, describing the 10 year risk to develop a characteristic complication (separately for myocardial infarction, stroke, kidney failure, blindness, amputation) and the potential to reduce this risk. These reports shall be used during consultations to help doctors and patients to communicate about diabetes associated risks and individual potential. The GP report shall ease doctor's therapy decisions. The patient report shall inform the patient to improve compliance, strengthen empowerment. The CDRM system gains this information by correlating the basic patient data plus the data from recent medical findings with the most recent diabetes research evidence. GPs of this intervention group will only get advice concerning how to use the CDRM system properly, no further (extra) intervention measures are permitted. In particular, no therapy recommendations from the research team to GPs how to decide on individual therapy or medication.

The control group will receive the T2DM care standard according to the National Guidelines issued by AWMF, within the framework of the National T2DM Disease Management Programme.

Conditions

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Diabetes Mellitus Type 2

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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risk profile information

patient gets information on quantitative individual complication risk profile and patient gets standard T2DM DMP care

Group Type EXPERIMENTAL

risk profile information

Intervention Type PROCEDURE

(1) patient on a regular basis receives individualized reports on his/her quantitative risk for 6 typical diabetes complications over the next 10 years, (2) standard T2DMP care, as outlined by AWMF diabetes guidelines

standard DMP care

Intervention Type PROCEDURE

standard disease management of T2DM care

Control

Control group: patient gets standard T2DM DMP care

Group Type ACTIVE_COMPARATOR

standard DMP care

Intervention Type PROCEDURE

standard disease management of T2DM care

Interventions

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risk profile information

(1) patient on a regular basis receives individualized reports on his/her quantitative risk for 6 typical diabetes complications over the next 10 years, (2) standard T2DMP care, as outlined by AWMF diabetes guidelines

Intervention Type PROCEDURE

standard DMP care

standard disease management of T2DM care

Intervention Type PROCEDURE

standard DMP care

standard disease management of T2DM care

Intervention Type PROCEDURE

Other Intervention Names

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risk calculator AWMF Guidelines oriented care risk calculator

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of T2DM,
* Enrollment in a T2DM RSAV DMP (German State Health Insurance DMP)

Exclusion Criteria

* Pregnant
* Dementia, psychoses, or other illness that would hinder compliance
* Serious illness such as:

* cancer,
* immune deficiency syndrome (HIV),
* genetic lipid disorder (e.g. autosomal dominant familial hypercholesteremia).
* Malabsorption syndromes such as colitis and Morbus Crohns disease.
* Bed-ridden or required supportive care
* Cardiac insufficiency \> NYHA class II
* Chronic metabolic storage illnesses such as Morbus Wilson or Amyloidosis.
* Endocrinologic diseases with elevated anti-insulin hormone (e.g. hyperthyreosis, pheochromocytoma, acromegaly.
* Chronic inflammatory diseases.
* Chronic therapy with corticosteroids, diazoxide.
* Pancreatic Diabetes mellitus (e.g. alcoholism, chronic pancreatitis, pancreatic resection)
* Any illness that would prevent the active involvement of the patient in the present study
* Prevalence of diabetes typical complications
Minimum Eligible Age

40 Years

Maximum Eligible Age

68 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Philipps University Marburg

OTHER

Sponsor Role lead

Responsible Party

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Prof. Ulrich Mueller

PROFESSOR

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ulrich O Mueller, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Medical School, Marburg University, Marburg, State of Hesse: Germany

Locations

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Philipps University Marburg Medical Center

Marburg, , Germany

Site Status

Countries

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Germany

Related Links

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http://www.drks.de

Deutsches Register Klinischer Studien (German Clinical Trials Register)

Other Identifiers

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CDRM 92/07/56

Identifier Type: -

Identifier Source: org_study_id

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