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Type 2 DiabetesiADAPTNCT01493258

Comprehensive Informatics Framework for Comparative Effectiveness Research (CER) Dissemination

A study testing iCOPE Intervention group in people with Type 2 Diabetes, run by Johns Hopkins University at 3 sites in United States.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

In this project the investigators seek to utilize our experience for developing a comprehensive informatics framework for rapid adaptation and dissemination of Comparative Effectiveness Research (CER) products tailored to different categories of health consumers including difficult-to-reach patients. Read more about this study

Who is it for?
Ages 65 years and older
Conditions the study is for
Type 2 Diabetes
What is being tested?
iCOPE Intervention group
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
3 sitesUnited States
Study dates
Aug 2010to not given
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 years and older
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • have clinical diagnosis of Type 2 diabetes;
  • take oral diabetes medications;
  • be 65 years of age or older at the time of randomization;
  • plan to remain in the Maryland/DC area until the completion of the study follow-up;
  • understand English at the 5th grade level.

Who cannot join

  • plan to leave Maryland/DC area before the completion of the study follow- up;
  • presence of significant cognitive impairment based on a Mini-Mental State Examination (MMSE) score ≤23
  • do not speak English.

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • Johns Hopkins University

    Baltimore, Maryland, 21205

  • Johns Hopkins Bayview Medical Center

    Baltimore, Maryland, 21224

  • Johns Hopkins University

    Baltimore, Maryland, 21224

Other trials in United States

About this study

In this project the investigators seek to utilize our experience for developing a comprehensive informatics framework for rapid adaptation and dissemination of Comparative Effectiveness Research (CER) products tailored to different categories of health consumers including difficult-to-reach patients. Based on our previous successful experience in computer-assisted education, the investigators will refine the current CO-ED platform to implement and test a novel system for individualized continuous patient education (iCOPE). The iCOPE platform will be specifically designed to support rapid adaptation, customization, and dissemination of the CER products to the difficult-to-reach populations. The iCOPE platform will implement universal means for customized delivery of CER information in the format of interactive self-paced educational modules, quick "question \& answer" guides, and interactive decision aids. In addition, the iCOPE platform will support the innovative concept of continuous patient health education by providing patients with easy access to the interactive CER updates via web, MP3 players and phone-based interactive voice response (IVR) technology. Though iCOPE will be designed to support the whole spectrum of CER products, in this project the investigators will focus on the Comparative Effectiveness Research Summary Guide (CERSG) entitled "Pills for Type 2 Diabetes."

The following primary hypothesis will be tested in the RCT: Use of the iCOPE platform will be associated with improvement in CERSG knowledge in elderly at 6 months after the intervention.

The investigators will also examine the impact of iCOPE on medication adherence self-efficacy, diabetes medication satisfaction, HbA1c, and CERSG acceptance.

Read the detailed description

Interactive, computer-based education has the potential to greatly increase interest, because the learner actively participates in the learning process (Fox, 2009). In addition, the involvement of auditory, visual, and interactive learning strategies can increase recall of information. Computer-assisted educational programs may incorporate features that promote ease of use, be written in multiple languages, be scripted at a level that addresses the needs of low literacy learners, and be viewed as often as needed by a patient (Fox, 2009).

Several studies reported results of using computer technology in educating elderly patients about health conditions. Stromberg et al (2006) used a single-session, interactive computer-based educational program about chronic heart failure in elderly patients. They demonstrated that interactive computer-mediated education may be effectively used to increase patients' knowledge, about heart failure. Another study, conducted by Lin et al (2009), evaluated the usability of a touch-screen-enabled personal education program (PEP). The results showed that the system was evaluated as usable and useful, and older adults were satisfied with their experience. Similar findings were reported by Neafsey et al (2008) who also evaluated a patient-centered computer-mediated program using touch screen computers. Authors reported high satisfaction of the older adult users, increased knowledge and self-efficacy for avoiding adverse self-medication behaviors.

Elderly patients are less likely than younger patients to seek incidental information on their condition via internet. (Tian \& Robinson, 2008) Elderly patients therefore are less likely to navigate internet looking for information about evidence or treatment guidelines for their conditions. More targeted efforts may be needed to reach such populations. Disseminating information via combination of high technology media along with traditional media that are easily usable is helpful (Longo, 2005). A recent review of barriers and drivers of health IT use by elderly, very ill, and underserved, revealed that such technology can play a role in offering effective interventions. The consumer perceptions on benefits from use of system, convenience of use, and familiar technology were all important factors for intervention success (Jimison et al., 2008).

Conditions
Type 2 Diabetes
Being tested
iCOPE Intervention group
Keywords
Diabetes, Comparative Effectiveness Research, Interactive computer-assisted education, Informatics
Medical subject headings
Diabetes Mellitus, Type 2, Diabetes Mellitus

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • iCOPE Intervention groupOther

    The study participants in the intervention group will use iCOPE platform providing adapted CERSG content in an interactive and tailored way. The intervention provided by the iCOPE platform will be implemented with the understanding that it should be user-friendly and not time consuming. Initially, all participants will be asked to complete the computer-mediated interactive CERSG module via touch screen tablet PC provided at hospital, in a primary care office, and in senior centers. The total time to complete the curriculum is about 30 min, however the patients will be able to distribute this time throughout a day at their convenience. Once the educational curriculum is completed, the intervention subjects will receive access to other components of the iCOPE platform.

Study groups in NCT01493258
Study groupRoleWhat they receive
Control GroupNo interventionThe study participants randomized to the Group 2 will serve as a control. At the beginning of the study, they will receive a CERSG brochure printed from the AHRQ site. They will be asked to study it to the best of their ability throughout the day.
iCOPE Intervention groupExperimentaliCOPE intervention group will receive a CERSG brochure via the iCOPE system.
Receives: Other: iCOPE Intervention group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in CERSG Knowledge Score from baseline to 24-hr and to 6-month follow up

    CERSG Knowledge Score will be used to assess the overall patient knowledge of the information provided in the CERSG entitled "Pills for Type 2 Diabetes." The score will represent a percentage of correct answers to 30 true/false items designed in accordance with the content of the CERSG.

    Measured: The Knowledge Test will be administered at the baseline, 24-hr after the introduction of the CERSG, and at the 6-month follow-up.

Secondary outcomes (4)
  1. Medication adherence self-efficacy

    Medication adherence self-efficacy will measure self-efficacy of taking medications.

    Measured: The medication adherence self-efficacy measure will be administered at the baseline, 24-hr after the introduction of the CERSG, and at the 6-month follow-up.

  2. Diabetes Medication Satisfaction

    Diabetes Medication Satisfaction measure is a diabetes-specific measure, assessing medication treatment satisfaction in three domains: Efficacy, Burden, Symptoms (Side Effects).

    Measured: Diabetes medication satisfaction measure will be administered at the baseline and at the 6-month follow-up.

  3. Glucosylated hemoglobin (HbA1c)

    Glucosylated hemoglobin (HbA1c) will be obtained from Electronic Medical Record (Centricity) at Johns Hopkins Community Physicians (JHCP).

    Measured: Glucosylated hemoglobin (HbA1c) values will be obtained closest to the date of the baseline evaluation and 6-month follow-up.

  4. CERSG Acceptance

    CERSG acceptance will measure patient acceptance and comprehension of CERSG

    Measured: The CERSG acceptance measure will be administered at the baseline, 24-hr after the introduction of the CERSG, and at the 6-month follow-up.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Dec 2011 (estimated)
  2. Study startAug 2010

Why it stopped: PI left JHU and is not able to be reached for updates

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01493258
Sponsor's protocol ID
NA_00040442
Acronym
iADAPT
Status last verified
May 2019
First submitted
9 Dec 2011
Last updated
18 May 2020
Results posted
No
Data monitoring committee
No
Individual data sharing
No: The data contain sensitive information

Publications

  • Tian Y, Robinson JD. Incidental health information use and media complementarity: a comparison of senior and non-senior cancer patients. Patient Educ Couns. 2008 Jun;71(3):340-4. doi: 10.1016/j.pec.2008.02.006. Epub 2008 Mar 26.

    PubMed 18372141
  • Neafsey PJ, Anderson E, Peabody S, Lin CA, Strickler Z, Vaughn K. Beta testing of a network-based health literacy program tailored for older adults with hypertension. Comput Inform Nurs. 2008 Nov-Dec;26(6):311-9. doi: 10.1097/01.NCN.0000336466.17811.e7.

    PubMed 19047879
  • Longo DR. Understanding health information, communication, and information seeking of patients and consumers: a comprehensive and integrated model. Health Expect. 2005 Sep;8(3):189-94. doi: 10.1111/j.1369-7625.2005.00339.x. No abstract available.

    PubMed 16098149
  • Jimison H, Gorman P, Woods S, Nygren P, Walker M, Norris S, Hersh W. Barriers and drivers of health information technology use for the elderly, chronically ill, and underserved. Evid Rep Technol Assess (Full Rep). 2008 Nov;(175):1-1422.

    PubMed 19408968
  • Lapshin OV, Sharma K, Finkelstein J. Depression education for primary care patients using a web-based program. AMIA Annu Symp Proc. 2005;2005:1017. No abstract available.

    PubMed 16779304
  • Finkelstein J, Lapshin O. Reducing depression stigma using a web-based program. Int J Med Inform. 2007 Oct;76(10):726-34. doi: 10.1016/j.ijmedinf.2006.07.004. Epub 2006 Sep 20.

    PubMed 16996299
  • Finkelstein J, Lapshin O, Cha E. Feasibility of promoting smoking cessation among methadone users using multimedia computer-assisted education. J Med Internet Res. 2008 Nov 3;10(5):e33. doi: 10.2196/jmir.1089.

    PubMed 18984556
  • Finkelstein J, Lapshin O, Wasserman E. Randomized study of different anti-stigma media. Patient Educ Couns. 2008 May;71(2):204-14. doi: 10.1016/j.pec.2008.01.002. Epub 2008 Mar 4.

    PubMed 18289823
  • Fitzgerald JT, Funnell MM, Hess GE, Barr PA, Anderson RM, Hiss RG, Davis WK. The reliability and validity of a brief diabetes knowledge test. Diabetes Care. 1998 May;21(5):706-10. doi: 10.2337/diacare.21.5.706.

    PubMed 9589228
  • Huang JP, Chen HH, Yeh ML. A comparison of diabetes learning with and without interactive multimedia to improve knowledge, control, and self-care among people with diabetes in Taiwan. Public Health Nurs. 2009 Jul-Aug;26(4):317-28. doi: 10.1111/j.1525-1446.2009.00786.x.

    PubMed 19573210
  • Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008 May;10(5):348-54. doi: 10.1111/j.1751-7176.2008.07572.x.

    PubMed 18453793
  • Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986 Jan;24(1):67-74. doi: 10.1097/00005650-198601000-00007.

    PubMed 3945130
  • Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005 Aug 4;353(5):487-97. doi: 10.1056/NEJMra050100. No abstract available.

    PubMed 16079372
  • Brod M, Christensen T, Kongso JH, Bushnell DM. Examining and interpreting responsiveness of the Diabetes Medication Satisfaction measure. J Med Econ. 2009;12(4):309-16. doi: 10.3111/13696990903337017.

    PubMed 19811109
  • Zeger SL, Liang KY, Albert PS. Models for longitudinal data: a generalized estimating equation approach. Biometrics. 1988 Dec;44(4):1049-60.

    PubMed 3233245

Questions about this trial

What is this clinical trial studying?

A study testing iCOPE Intervention group in people with Type 2 Diabetes, run by Johns Hopkins University at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 18 May 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in CERSG Knowledge Score from baseline to 24-hr and to 6-month follow up (time frame: The Knowledge Test will be administered at the baseline, 24-hr after the introduction of the CERSG, and at the 6-month follow-up.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01493258, which also lists 15 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2020.

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