Effect of a Web-Based Management Guide on Risk Factors in Patients With Type 2 Diabetes and Diabetic Kidney Disease: A JADE Randomized Clinical Trial

Diabetic kidney disease (DKD) and its comorbidities can be prevented by treating multiple targets. Technology-assisted team-based care with regular feedback and patient empowerment can improve the attainment of multiple targets and clinical outcomes in patients with type 2 diabetes, but the effects...

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Bibliographic Details
Published in:JAMA network open 2022-03, Vol.5 (3), p.e223862-e223862
Main Authors: Chan, Juliana C N, Thewjitcharoen, Yotsapon, Nguyen, Thy Khue, Tan, Alexander, Chia, Yook-Chin, Hwu, Chii-Min, Jian, Du, Himathongkam, Thep, Wong, Kim-Leng, Choi, Yun-Mi, Mirasol, Roberto, Mohamed, Mafauzy, Kong, Alice P S, Ma, Ronald C W, Chow, Elaine Y K, Ozaki, Risa, Lau, Vanessa, Fu, Amy W C, Hong, Eun-Gyoung, Yoon, Kun-Ho, Tsang, Chiu-Chi, Lau, Eric S H, Lim, Lee-Ling, Luk, Andrea O Y
Format: Article
Language:English
Subjects:
Aged
Clinical trials
Diabetes
Diabetes and Endocrinology
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - epidemiology
Diabetes Mellitus, Type 2 - therapy
Diabetic Nephropathies - therapy
Diabetic nephropathy
Empowerment
Humans
Internet
Kidney diseases
Male
Online Only
Original Investigation
Risk Factors
Web portals
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Summary:Diabetic kidney disease (DKD) and its comorbidities can be prevented by treating multiple targets. Technology-assisted team-based care with regular feedback and patient empowerment can improve the attainment of multiple targets and clinical outcomes in patients with type 2 diabetes, but the effects of this intervention on patients with DKD are unclear. To evaluate the effect of the Joint Asia Diabetes Evaluation (JADE) web portal, nurse reminders, and team-based care on multiple risk factors in patients with DKD. This 12-month multinational, open-label randomized clinical trial was conducted between June 27, 2014, and February 19, 2019, at 13 hospital-based diabetes centers in 8 countries or regions in Asia. All patients who participated had DKD. The intention-to-treat data analysis was performed from April 7 to June 30, 2020. Patients were randomized in a 1:1:1 ratio at each site to usual care, empowered care, or team-based empowered care. All patients underwent a JADE web portal-guided structured assessment at baseline and month 12. Patients in the usual care and empowered care groups received a medical follow-up. Patients in the empowered care group also received a personalized JADE report and nurse telephone calls every 3 months. Patients in the team-based empowered care group received additional face-to-face reviews every 3 months from a physician-nurse team. The primary outcome was the proportion of patients who attained multiple treatment targets (defined as ≥3 of 5 targets: HbA1c level
ISSN:2574-3805
2574-3805
DOI:10.1001/jamanetworkopen.2022.3862