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利用远程医疗同时控制危险因素以延缓糖尿病肾病进展(STOP-DKD)研究:一项随机对照试验的方案和基线特征

Simultaneous Risk Factor Control Using Telehealth to slOw Progression of Diabetic Kidney Disease (STOP-DKD) study: Protocol and baseline characteristics of a randomized controlled trial.

作者信息

Diamantidis Clarissa J, Bosworth Hayden B, Oakes Megan M, Davenport Clemontina A, Pendergast Jane F, Patel Sejal, Moaddeb Jivan, Barnhart Huiman X, Merrill Peter D, Baloch Khaula, Crowley Matthew J, Patel Uptal D

机构信息

Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, United States; Division of Nephrology, Duke University School of Medicine, Durham, NC, United States.

Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, United States; Center for Health Services Research in Primary Medicine, Durham VAMC, United States; Department of Population Health Science, Duke University School of Medicine, Durham, NC, United States.

出版信息

Contemp Clin Trials. 2018 Jun;69:28-39. doi: 10.1016/j.cct.2018.04.003. Epub 2018 Apr 10.

Abstract

UNLABELLED

Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease (ESKD) in the United States. Multiple risk factors contribute to DKD development, yet few interventions target more than a single DKD risk factor at a time. This manuscript describes the study protocol, recruitment, and baseline participant characteristics for the Simultaneous Risk Factor Control Using Telehealth to slOw Progression of Diabetic Kidney Disease (STOP-DKD) study. The STOP-DKD study is a randomized controlled trial designed to evaluate the effectiveness of a multifactorial behavioral and medication management intervention to mitigate kidney function decline at 3 years compared to usual care. The intervention consists of up to 36 monthly educational modules delivered via telephone by a study pharmacist, home blood pressure monitoring, and medication management recommendations delivered electronically to primary care physicians. Patients seen at seven primary care clinics in North Carolina, with diabetes and [1] uncontrolled hypertension and [2] evidence of kidney dysfunction (albuminuria or reduced estimated glomerular filtration rate [eGFR]) were eligible to participate. Study recruitment completed in December 2014. Of the 281 participants randomized, mean age at baseline was 61.9; 52% were male, 56% were Black, and most were high school graduates (89%). Baseline co-morbidity was high- mean blood pressure was 134/76 mmHg, mean body mass index was 35.7 kg/m, mean eGFR was 80.7 ml/min/1.73 m, and mean glycated hemoglobin was 8.0%. Experiences of recruiting and implementing a comprehensive DKD program to individuals at high risk seen in the primary care setting are provided.

TRIAL REGISTRATION

NCT01829256.

摘要

未标注

糖尿病肾病(DKD)是美国终末期肾病(ESKD)的主要病因。多种风险因素导致DKD的发生,但目前很少有干预措施能同时针对多个DKD风险因素。本文描述了使用远程医疗同时控制风险因素以延缓糖尿病肾病进展(STOP-DKD)研究的研究方案、招募情况及参与者基线特征。STOP-DKD研究是一项随机对照试验,旨在评估多因素行为和药物管理干预措施与常规护理相比,在3年内减轻肾功能下降的有效性。干预措施包括由研究药剂师通过电话提供多达36个月度教育模块、家庭血压监测以及以电子方式向初级保健医生提供药物管理建议。在北卡罗来纳州七家初级保健诊所就诊的糖尿病患者,若同时具备[1]未控制的高血压和[2]肾功能不全证据(蛋白尿或估算肾小球滤过率[eGFR]降低),则有资格参与。研究招募工作于2014年12月完成。在随机分组的281名参与者中,基线平均年龄为61.9岁;52%为男性,56%为黑人,大多数为高中毕业生(89%)。基线合并症较多——平均血压为134/76 mmHg,平均体重指数为35.7 kg/m²,平均eGFR为80.7 ml/min/1.73 m²,平均糖化血红蛋白为8.0%。本文还介绍了在初级保健环境中针对高危个体开展综合DKD项目的招募和实施经验。

试验注册号

NCT01829256。

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