Trial Outcomes & Findings for COMRADE: Collaborative Care Management for Distress and Depression in Rural Diabetes (NCT NCT02863523)

NCT ID: NCT02863523

Last Updated: 2023-12-08

Results Overview

Change from baseline in HbA1c or glycosylated hemoglobin (%)

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

139 participants

Primary outcome timeframe

Baseline to 12 months

Results posted on

2023-12-08

Participant Flow

Participant milestones

Participant milestones
Measure
Integrated Behavioral Intervention
Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care. Integrated Behavioral Care: Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care.
Usual Care
Patients receive usual care
Overall Study
STARTED
67
72
Overall Study
COMPLETED
67
72
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

COMRADE: Collaborative Care Management for Distress and Depression in Rural Diabetes

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Integrated Behavioral Intervention
n=67 Participants
Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care. Integrated Behavioral Care: Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care.
Usual Care
n=72 Participants
Patients receive usual care
Total
n=139 Participants
Total of all reporting groups
Age, Continuous
52.67 years
STANDARD_DEVIATION 9.67 • n=5 Participants
54.71 years
STANDARD_DEVIATION 9.3 • n=7 Participants
53.7 years
STANDARD_DEVIATION 9.5 • n=5 Participants
Sex: Female, Male
Female
53 Participants
n=5 Participants
55 Participants
n=7 Participants
108 Participants
n=5 Participants
Sex: Female, Male
Male
14 Participants
n=5 Participants
17 Participants
n=7 Participants
31 Participants
n=5 Participants
Race/Ethnicity, Customized
African American
53 Participants
n=5 Participants
48 Participants
n=7 Participants
101 Participants
n=5 Participants
Race/Ethnicity, Customized
White or mixed race
14 Participants
n=5 Participants
24 Participants
n=7 Participants
38 Participants
n=5 Participants
Region of Enrollment
United States
67 Participants
n=5 Participants
72 Participants
n=7 Participants
139 Participants
n=5 Participants
HbA1c
9.8 percent
STANDARD_DEVIATION 2.1 • n=5 Participants
9.3 percent
STANDARD_DEVIATION 1.7 • n=7 Participants
9.6 percent
STANDARD_DEVIATION 1.9 • n=5 Participants

PRIMARY outcome

Timeframe: Baseline to 12 months

Change from baseline in HbA1c or glycosylated hemoglobin (%)

Outcome measures

Outcome measures
Measure
Integrated Behavioral Intervention
n=67 Participants
Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care. Integrated Behavioral Care: Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care.
Usual Care
n=72 Participants
Patients receive usual care
Change From Baseline in Glycosylated Hemoglobin (%)
-0.92 change from baseline in A1c (%)
Standard Deviation 1.8
-0.31 change from baseline in A1c (%)
Standard Deviation 2.0

SECONDARY outcome

Timeframe: Baseline to 12 months

Diabetes regimen-related distress is a measure of the emotional response to having and managing diabetes and is measured by a subscale of 5 items (#5, 6, 10, 12, 16) from the Diabetes-related Distress instrument (DDS-17). Each item is rated from 1 (not a problem) - 6 (very serious problem) and therefore the total score for this sub-score ranges from 5 - 30. The mean score for an individual can be computed as the sum of the 5 items divided by 5. For this study outcome, the investigators computed the average change (increase or decrease) in the mean RRD score from baseline to 12-mo. follow-up.

Outcome measures

Outcome measures
Measure
Integrated Behavioral Intervention
n=67 Participants
Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care. Integrated Behavioral Care: Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care.
Usual Care
n=72 Participants
Patients receive usual care
Change From Baseline in Diabetes Regimen-Related Distress
-1.1 score on a scale
Standard Deviation 1.0
-0.3 score on a scale
Standard Deviation 1.2

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline to 12 months

Diabetes self-care activities as measured by the Self-reported Diabetes Self Care Activities (SDSCA) instrument. The SDSCA is a questionnaire which assesses levels of self-care in adults with diabetes. The tool contains 11 items, which measure the frequency of performing diabetes self-care activities over the last seven days including diet, exercise, blood glucose testing, foot care and tobacco use. The respondent marks the number of days on which the indicated behavior was performed on an eight-point Likert scale (0 - 7) to answer the questions. The first ten items are summed to a total score. The eleventh item focuses on smoking habits and assesses the average number of cigarettes smoked per day. For the present study, the total score was summed and divided by 11 items to create a mean score and then the average change from baseline to 12 month follow-up.

Outcome measures

Outcome measures
Measure
Integrated Behavioral Intervention
n=67 Participants
Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care. Integrated Behavioral Care: Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care.
Usual Care
n=72 Participants
Patients receive usual care
Change in Diabetes Self-care Activities
1.1 score on a scale
Standard Deviation 1.3
0.58 score on a scale
Standard Deviation 1.4

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline to 12 months

Change in depressive symptoms as measured by the Patient Health Questionnaire-9 (PHQ-9) instrument for depressive symptoms. Diagnosis based on Total PHQ-9 Score; Interpretation: Minimal depression 0-4 Mild depression 5-9 Moderate depression 10-14 Moderately severe depression 15-19 Severe depression 20-27

Outcome measures

Outcome measures
Measure
Integrated Behavioral Intervention
n=67 Participants
Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care. Integrated Behavioral Care: Patients receive intensive behavioral counseling that may include elements of cognitive behavioral therapy, problem solving therapy, and small changes lifestyle counseling in addition to medical care.
Usual Care
n=72 Participants
Patients receive usual care
Change in Depressive Symptoms
-3.4 score on a scale
Standard Deviation 5.0
-0.9 score on a scale
Standard Deviation 6.2

Adverse Events

Integrated Behavioral Intervention

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Usual Care

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Doyle Cummings

East Carolina University

Phone: 252-744-2607

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place