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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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| Published in: | JAMA network open 2022-03, Vol.5 (3), p.e223862-e223862 |
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| creator | 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 |
| description | 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 |
| doi_str_mv | 10.1001/jamanetworkopen.2022.3862 |
| format | article |
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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 <7.0% [53 mmol/mol], blood pressure <130/80 mm Hg, low-density lipoprotein cholesterol level <1.8 mmol/L, triglyceride level <1.7 mmol/L, and/or persistent use of renin-angiotensin-aldosterone system inhibitors).
A total of 2393 patients (mean [SD] age, 67.7 [9.8] years; 1267 men [52.9%]) were randomized to the usual care group (n = 795), empowered care group (n = 802), and team-based empowered care group (n = 796). At baseline, 34.7% patients (n = 830) were on 3 treatment targets. On intention-to-treat analysis, the team-based empowered care group had the highest proportion of patients who had further increase in attainment of multiple treatment targets (within-group differences: usual care group, 3.9% [95% CI, 0.0%-7.8%]; empowered care group, 1.3% [95% CI, -2.8% to 5.4%]; team-based empowered care group, 9.1% [95% CI, 4.7%-13.5%]). The team-based empowered care group was more likely to attain multiple treatment targets than the usual care group (risk ratio [RR], 1.17; 95% CI, 1.00-1.37) and the empowered care group (RR, 1.25; 95% CI, 1.06-1.48) after adjustment for site. Compared with the group that did not attain multiple treatment targets, the group that attained multiple treatment targets reported a lower incidence of cardiovascular, kidney, and cancer events (8.4% [n = 51] vs 14.5% [n = 134]; P = .004). Analysis of the per-protocol population yielded similar results.
This trial found that technology-assisted team-based care for 12 months improved the attainment of multiple treatment targets as well as empowerment in patients with DKD.
ClinicalTrials.gov Identifier: NCT02176278.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2022.3862</identifier><identifier>PMID: 35333363</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>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</subject><ispartof>JAMA network open, 2022-03, Vol.5 (3), p.e223862-e223862</ispartof><rights>2022. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright 2022 Chan JCN et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c344t-ebceced3a3edde9e8d75c8574e3de7272d23824456c002d1d7ac01f64a22f3e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2665608588?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,25753,27924,27925,37012,37013,44590</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35333363$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Juliana C N</creatorcontrib><creatorcontrib>Thewjitcharoen, Yotsapon</creatorcontrib><creatorcontrib>Nguyen, Thy Khue</creatorcontrib><creatorcontrib>Tan, Alexander</creatorcontrib><creatorcontrib>Chia, Yook-Chin</creatorcontrib><creatorcontrib>Hwu, Chii-Min</creatorcontrib><creatorcontrib>Jian, Du</creatorcontrib><creatorcontrib>Himathongkam, Thep</creatorcontrib><creatorcontrib>Wong, Kim-Leng</creatorcontrib><creatorcontrib>Choi, Yun-Mi</creatorcontrib><creatorcontrib>Mirasol, Roberto</creatorcontrib><creatorcontrib>Mohamed, Mafauzy</creatorcontrib><creatorcontrib>Kong, Alice P S</creatorcontrib><creatorcontrib>Ma, Ronald C W</creatorcontrib><creatorcontrib>Chow, Elaine Y K</creatorcontrib><creatorcontrib>Ozaki, Risa</creatorcontrib><creatorcontrib>Lau, Vanessa</creatorcontrib><creatorcontrib>Fu, Amy W C</creatorcontrib><creatorcontrib>Hong, Eun-Gyoung</creatorcontrib><creatorcontrib>Yoon, Kun-Ho</creatorcontrib><creatorcontrib>Tsang, Chiu-Chi</creatorcontrib><creatorcontrib>Lau, Eric S H</creatorcontrib><creatorcontrib>Lim, Lee-Ling</creatorcontrib><creatorcontrib>Luk, Andrea O Y</creatorcontrib><title>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</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>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 <7.0% [53 mmol/mol], blood pressure <130/80 mm Hg, low-density lipoprotein cholesterol level <1.8 mmol/L, triglyceride level <1.7 mmol/L, and/or persistent use of renin-angiotensin-aldosterone system inhibitors).
A total of 2393 patients (mean [SD] age, 67.7 [9.8] years; 1267 men [52.9%]) were randomized to the usual care group (n = 795), empowered care group (n = 802), and team-based empowered care group (n = 796). At baseline, 34.7% patients (n = 830) were on 3 treatment targets. On intention-to-treat analysis, the team-based empowered care group had the highest proportion of patients who had further increase in attainment of multiple treatment targets (within-group differences: usual care group, 3.9% [95% CI, 0.0%-7.8%]; empowered care group, 1.3% [95% CI, -2.8% to 5.4%]; team-based empowered care group, 9.1% [95% CI, 4.7%-13.5%]). The team-based empowered care group was more likely to attain multiple treatment targets than the usual care group (risk ratio [RR], 1.17; 95% CI, 1.00-1.37) and the empowered care group (RR, 1.25; 95% CI, 1.06-1.48) after adjustment for site. Compared with the group that did not attain multiple treatment targets, the group that attained multiple treatment targets reported a lower incidence of cardiovascular, kidney, and cancer events (8.4% [n = 51] vs 14.5% [n = 134]; P = .004). Analysis of the per-protocol population yielded similar results.
This trial found that technology-assisted team-based care for 12 months improved the attainment of multiple treatment targets as well as empowerment in patients with DKD.
ClinicalTrials.gov Identifier: NCT02176278.</description><subject>Aged</subject><subject>Clinical trials</subject><subject>Diabetes</subject><subject>Diabetes and Endocrinology</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - therapy</subject><subject>Diabetic Nephropathies - therapy</subject><subject>Diabetic nephropathy</subject><subject>Empowerment</subject><subject>Humans</subject><subject>Internet</subject><subject>Kidney diseases</subject><subject>Male</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Risk Factors</subject><subject>Web portals</subject><issn>2574-3805</issn><issn>2574-3805</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpdkd1uEzEQhVcIRKvSV0CDuOFmg9de7w8XSCFNy08RqIrUS2tiz7ZOd-1gb0Dpe_R9cdRQlfpmPJpvjn10suxNwSYFY8X7FQ7oaPzjw41fk5twxvlENBV_lh1yWZe5aJh8_uh-kB3HuGKMcVaItpIvswMhRTqVOMzu5l1HegTfAcIlLfNPGMnAd3R4RQO5Ec421hB4Bxc23sAp6tGHCNbBTxxtAiJc2vEaFts1AYcTi0saKQI6s2-shm_WONqmPlKS_wBT-Do9mcNFgvxgb9ODs946q7GHRbDYv8pedNhHOt7Xo2xxOl_MPufnP86-zKbnuRZlOea01KTJCBRkDLXUmFrqJvkmYajmNTdcNLwsZaWTe1OYGjUruqpEzjtB4ij7eC-73iwHMjq5CdirdbADhq3yaNX_E2ev1ZX_rZpWVm0tksC7vUDwvzYURzXYqKnvU0J-ExWvypKxWrQyoW-foCu_CS65S1QlK9bIpklUe0_p4GMM1D18pmBqF796Er_axa928afd14_dPGz-C1v8BYqdsXo</recordid><startdate>20220325</startdate><enddate>20220325</enddate><creator>Chan, Juliana C N</creator><creator>Thewjitcharoen, Yotsapon</creator><creator>Nguyen, Thy Khue</creator><creator>Tan, Alexander</creator><creator>Chia, Yook-Chin</creator><creator>Hwu, Chii-Min</creator><creator>Jian, Du</creator><creator>Himathongkam, Thep</creator><creator>Wong, Kim-Leng</creator><creator>Choi, Yun-Mi</creator><creator>Mirasol, Roberto</creator><creator>Mohamed, Mafauzy</creator><creator>Kong, Alice P S</creator><creator>Ma, Ronald C W</creator><creator>Chow, Elaine Y K</creator><creator>Ozaki, Risa</creator><creator>Lau, Vanessa</creator><creator>Fu, Amy W C</creator><creator>Hong, Eun-Gyoung</creator><creator>Yoon, Kun-Ho</creator><creator>Tsang, Chiu-Chi</creator><creator>Lau, Eric S H</creator><creator>Lim, Lee-Ling</creator><creator>Luk, Andrea O Y</creator><general>American Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220325</creationdate><title>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</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-ebceced3a3edde9e8d75c8574e3de7272d23824456c002d1d7ac01f64a22f3e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Clinical trials</topic><topic>Diabetes</topic><topic>Diabetes and Endocrinology</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - therapy</topic><topic>Diabetic Nephropathies - therapy</topic><topic>Diabetic nephropathy</topic><topic>Empowerment</topic><topic>Humans</topic><topic>Internet</topic><topic>Kidney diseases</topic><topic>Male</topic><topic>Online Only</topic><topic>Original Investigation</topic><topic>Risk Factors</topic><topic>Web portals</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Juliana C N</creatorcontrib><creatorcontrib>Thewjitcharoen, Yotsapon</creatorcontrib><creatorcontrib>Nguyen, Thy Khue</creatorcontrib><creatorcontrib>Tan, Alexander</creatorcontrib><creatorcontrib>Chia, Yook-Chin</creatorcontrib><creatorcontrib>Hwu, Chii-Min</creatorcontrib><creatorcontrib>Jian, Du</creatorcontrib><creatorcontrib>Himathongkam, Thep</creatorcontrib><creatorcontrib>Wong, Kim-Leng</creatorcontrib><creatorcontrib>Choi, Yun-Mi</creatorcontrib><creatorcontrib>Mirasol, Roberto</creatorcontrib><creatorcontrib>Mohamed, Mafauzy</creatorcontrib><creatorcontrib>Kong, Alice P S</creatorcontrib><creatorcontrib>Ma, Ronald C W</creatorcontrib><creatorcontrib>Chow, Elaine Y K</creatorcontrib><creatorcontrib>Ozaki, Risa</creatorcontrib><creatorcontrib>Lau, Vanessa</creatorcontrib><creatorcontrib>Fu, Amy W C</creatorcontrib><creatorcontrib>Hong, Eun-Gyoung</creatorcontrib><creatorcontrib>Yoon, Kun-Ho</creatorcontrib><creatorcontrib>Tsang, Chiu-Chi</creatorcontrib><creatorcontrib>Lau, Eric S H</creatorcontrib><creatorcontrib>Lim, Lee-Ling</creatorcontrib><creatorcontrib>Luk, Andrea O Y</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection (ProQuest Medical & Health Databases)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JAMA network open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, Juliana C N</au><au>Thewjitcharoen, Yotsapon</au><au>Nguyen, Thy Khue</au><au>Tan, Alexander</au><au>Chia, Yook-Chin</au><au>Hwu, Chii-Min</au><au>Jian, Du</au><au>Himathongkam, Thep</au><au>Wong, Kim-Leng</au><au>Choi, Yun-Mi</au><au>Mirasol, Roberto</au><au>Mohamed, Mafauzy</au><au>Kong, Alice P S</au><au>Ma, Ronald C W</au><au>Chow, Elaine Y K</au><au>Ozaki, Risa</au><au>Lau, Vanessa</au><au>Fu, Amy W C</au><au>Hong, Eun-Gyoung</au><au>Yoon, Kun-Ho</au><au>Tsang, Chiu-Chi</au><au>Lau, Eric S H</au><au>Lim, Lee-Ling</au><au>Luk, Andrea O Y</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>JAMA network open</jtitle><addtitle>JAMA Netw Open</addtitle><date>2022-03-25</date><risdate>2022</risdate><volume>5</volume><issue>3</issue><spage>e223862</spage><epage>e223862</epage><pages>e223862-e223862</pages><issn>2574-3805</issn><eissn>2574-3805</eissn><abstract>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 <7.0% [53 mmol/mol], blood pressure <130/80 mm Hg, low-density lipoprotein cholesterol level <1.8 mmol/L, triglyceride level <1.7 mmol/L, and/or persistent use of renin-angiotensin-aldosterone system inhibitors).
A total of 2393 patients (mean [SD] age, 67.7 [9.8] years; 1267 men [52.9%]) were randomized to the usual care group (n = 795), empowered care group (n = 802), and team-based empowered care group (n = 796). At baseline, 34.7% patients (n = 830) were on 3 treatment targets. On intention-to-treat analysis, the team-based empowered care group had the highest proportion of patients who had further increase in attainment of multiple treatment targets (within-group differences: usual care group, 3.9% [95% CI, 0.0%-7.8%]; empowered care group, 1.3% [95% CI, -2.8% to 5.4%]; team-based empowered care group, 9.1% [95% CI, 4.7%-13.5%]). The team-based empowered care group was more likely to attain multiple treatment targets than the usual care group (risk ratio [RR], 1.17; 95% CI, 1.00-1.37) and the empowered care group (RR, 1.25; 95% CI, 1.06-1.48) after adjustment for site. Compared with the group that did not attain multiple treatment targets, the group that attained multiple treatment targets reported a lower incidence of cardiovascular, kidney, and cancer events (8.4% [n = 51] vs 14.5% [n = 134]; P = .004). Analysis of the per-protocol population yielded similar results.
This trial found that technology-assisted team-based care for 12 months improved the attainment of multiple treatment targets as well as empowerment in patients with DKD.
ClinicalTrials.gov Identifier: NCT02176278.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>35333363</pmid><doi>10.1001/jamanetworkopen.2022.3862</doi><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 2574-3805 |
| ispartof | JAMA network open, 2022-03, Vol.5 (3), p.e223862-e223862 |
| issn | 2574-3805 2574-3805 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8956973 |
| source | Publicly Available Content Database |
| 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 |
| title | 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 |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T14%3A00%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20a%20Web-Based%20Management%20Guide%20on%20Risk%20Factors%20in%20Patients%20With%20Type%202%20Diabetes%20and%20Diabetic%20Kidney%20Disease:%20A%20JADE%20Randomized%20Clinical%20Trial&rft.jtitle=JAMA%20network%20open&rft.au=Chan,%20Juliana%20C%20N&rft.date=2022-03-25&rft.volume=5&rft.issue=3&rft.spage=e223862&rft.epage=e223862&rft.pages=e223862-e223862&rft.issn=2574-3805&rft.eissn=2574-3805&rft_id=info:doi/10.1001/jamanetworkopen.2022.3862&rft_dat=%3Cproquest_pubme%3E2644007395%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c344t-ebceced3a3edde9e8d75c8574e3de7272d23824456c002d1d7ac01f64a22f3e3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2665608588&rft_id=info:pmid/35333363&rfr_iscdi=true |