Internet-based Diabetes Education and Case Management

US Department of Veterans Affairs (VA)

Status: Completed

Conditions: Hypertension; Diabetes Mellitus

Treatments: Procedure: Telephone and face-to-face care management; Procedure: Web-based care management; Procedure: Internet access alone

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT00105898

TEL 02-100

Details and patient eligibility

About

This study is comparing the effectiveness of web-based care management to either telephone-based care management or internet access alone, in patients with poorly controlled diabetes mellitus.

Full description

Background:

Patients with diabetes and elevated hemoglobin A1c (HbA1c) are at risk for diabetes-related complications. Care-management may be helpful in these patients, by providing direct contact between such high-risk patients and the healthcare system. Web-based systems have previously shown promise as a means of neutralizing access barriers such as scheduling and travel to appointments and may be of particular help in improving diabetes care.

Objectives:

We examined the efficacy of two methods of diabetes education and care management: (1) a traditional model that involved telephone contact and face-to-face encounters (2) a web-based model with access to a diabetes care management web site. We compared these interventions to a study group that received no education or care management but was provided with a computer and access to diabetes self-management websites.

Methods:

This study employed a randomized, parallel group design involving patients with diabetes mellitus and an elevated HbA1c ( 8.5%). Participants assigned to web-based care management received a notebook computer, Internet access and interacted with a care manager through a diabetes education and care management website. Participants receiving telephone-based care management interacted with a care manager using telephone and face-to-face contact. Both care management models employed medication algorithms to improve glucose and BP control. These care management groups were compared to a study group that had no care management but received a notebook computer and Internet access with their "home page" containing links to a series of diabetes self-management websites (i.e. computer only group). The primary outcome measures were HbA1c, blood pressure, and scores on the Problem Areas in Diabetes (PAID) questionnaire, each measured over 12-months.

Status:

Complete

Enrollment: 152 patients

Sex: All

Ages: 25 to 79 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosis of diabetes mellitus
• Age 25-79 years
• HbA1c >=8.5%
• Ability to speak and understand English
• Telephone access
• VA-based primary care provider
• Interest in using a glucose and BP monitor and notebook computer

Exclusion criteria

• Visual impairment that affects ability to read

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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152 participants in 3 patient groups

Arm 1

Experimental group

Description:

Intervention group

Treatment:

Procedure: Web-based care management

Arm 2

Active Comparator group

Description:

Comparator

Treatment:

Procedure: Telephone and face-to-face care management

Arm 3

Sham Comparator group

Description:

Comparator

Treatment:

Procedure: Internet access alone