Evidence map›Paper›PMID 32700217›Full record

Trial reportJournal of general internal medicine2021

A Telehealth-supported, Integrated care with CHWs, and MEdication-access (TIME) Program for Diabetes Improves HbA1c: a Randomized Clinical Trial.

Elizabeth M Vaughan, David J Hyman, Aanand D Naik, Susan L Samson, Javad Razjouyan, John P Foreyt

2 registry-linked trialsOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 37 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 10 pooled it
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03394456 nacompletednot on this map

Technology to Improve the Health of Resource-poor Hispanics With Diabetes

TypeinterventionalSponsorBaylor College of MedicineRan2018 to 2022Enrolled265ConditionsDiabetes Mellitus, Type 2Armsdiabetes program, telehealth training and support for Community Health Workers
NCT07538505 nanot yet recruitingnot on this mapstarted 2027, after this paper: background citation

Implementing a Diabetes Intervention in Rural and Low-Income Clinics: A Feasibility Study

TypeinterventionalSponsorThe University of Texas Medical Branch, GalvestonRan2027 to 2031Enrolled200ConditionsType 2 Diabetes MellitusArmsCommunity Health Worker-led diabetes program
3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 10 syntheses or guidelines pooled it, 51 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Elizabeth M VaughanDivision of General Internal Medicine, Department of Medicine , Baylor College of Medicine, Houston, TX, USA. elizabeth.vaughan@bcm.edu.ORCID 0000-0001-9565-0134
David J HymanDivision of General Internal Medicine, Department of Medicine , Baylor College of Medicine, Houston, TX, USA.
Aanand D NaikDivision of General Internal Medicine, Department of Medicine , Baylor College of Medicine, Houston, TX, USA.
Susan L SamsonSection of Endocrinology, Diabetes and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, USA.
Javad RazjouyanCenter for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E DeBakey VA Medical Center, Houston, TX, USA.
John P ForeytDivision of General Internal Medicine, Department of Medicine , Baylor College of Medicine, Houston, TX, USA.
Baylor College of Medicine · USMichael E. DeBakey VA Medical Center · US

Funding

NIDDK NIH HHS K23 DK110341
6 · The paper itself

Abstract

backgroundMany individuals with diabetes live in low- or middle-income settings. Glycemic control is challenging, particularly in resource-limited areas that face numerous healthcare barriers.

objectiveTo compare HbA1c outcomes for individuals randomized to TIME, a Telehealth-supported, Integrated care with CHWs (Community Health Workers), and MEdication-access program (intervention) versus usual care (wait-list control).

designRandomized clinical trial.

participantsLow-income Latino(a) adults with type 2 diabetes.

interventionsTIME consisted of (1) CHW-participant telehealth communication via mobile health (mHealth) for 12 months, (2) CHW-led monthly group visits for 6 months, and (3) weekly CHW-physician diabetes training and support via telehealth (video conferencing). MAIN MEASURES: Investigators compared TIME versus control participant baseline to month 6 changes of HbA1c (primary outcome), blood pressure, body mass index (BMI), weight, and adherence to seven American Diabetes Association (ADA) standards of care. CHW assistance in identifying barriers to healthcare in the intervention group were measured at the end of mHealth communication (12 months). KEY

resultsA total of 89 individuals participated. TIME individuals compared to control participants had significant HbA1c decreases (9.02 to 7.59% (- 1.43%) vs. 8.71 to 8.26% (- 0.45%), respectively, p = 0.002), blood pressure changes (systolic: - 6.89 mmHg vs. 0.03 mmHg, p = 0.023; diastolic: - 3.36 mmHg vs. 0.2 mmHg, respectively, p = 0.046), and ADA guideline adherence (p < 0.001) from baseline to month 6. At month 6, more TIME than control participants achieved > 0.50% HbA1c reductions (88.57% vs. 43.75%, p < 0.001). BMI and weight changes were not significant between groups. Many (54.6%) TIME participants experienced > 1 barrier to care, of whom 91.7% had medication issues. CHWs identified the majority (87.5%) of barriers.

conclusionsTIME participants resulted in improved outcomes including HbA1c. CHWs are uniquely positioned to identify barriers to care particularly related to medications that may have gone unrecognized otherwise. Larger trials are needed to determine the scalability and sustainability of the intervention. CLINICAL TRIAL: NCT03394456, accessed at https://clinicaltrials.gov/ct2/show/NCT03394456.

Indexed as

Delivery of Health Care, IntegratedDiabetes Mellitus, Type 2TelemedicineAdultGlycated HemoglobinHealth Services AccessibilityHumansGlycated Hemoglobincommunity health workerdiabetesgroup visits or shared medical appointmentslow-incomemedicationobesity

Identifiers

PMID32700217
PMCPMC7878600
OpenAlexW3045486530

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.