Coordinating Cardiology clinics randomized trial of interventions to improve outcomes (COORDINATE) – Diabetes: rationale and design - 12/01/23

Doi : 10.1016/j.ahj.2022.10.079

Adam J. Nelson, MBBS, MPH, MBA, PhD ^a, Neha J. Pagidipati, MD, MPH ^a, Michelle D. Kelsey, MD, MHS ^a, Maddalena Ardissino, MBBS ^a, Vanita R. Aroda, MD ^b, Matthew A. Cavender, MD, MPH ^c, Renato D. Lopes, MD, PhD ^a, Hussein R. Al-Khalidi, PhD ^a, Rogelio Braceras, MD ^d, Tanya Gaynor, MPAS, PA-C ^d, Lisa A. Kaltenbach, MS ^a, Julienne K. Kirk, BS PharmD ^e, Ildiko Lingvay, MD, MPH, MSCS ^f, Melissa L. Magwire, MSN, RN ^g, Emily C. O'Brien, PhD ^a, Jonathan Pak, PharmD, MBA ^d, Rodica Pop-Busui, MD, PhD ^h, Caroline R. Richardson, MD ^h, Monica Levya, RCIS, MHA ^a, Cagri Senyucel, MD, PhD ⁱ, Laura Webb, BS CCRP ^a, Darren K. McGuire, MD MHS ^f,^j, Jennifer B. Green, MD ^a, Christopher B. Granger, MD ^a,^⁎
^a Duke Clinical Research Institute, Durham, NC
^b Brigham and Women's Hospital, Boston, MA
^c University of North Carolina, Chapel Hill, NC
^d Boehringer Ingelheim Pharmaceuticals, Inc. Ridgefield, CT
^e Wake Forest University School of Medicine, Winston Salem, NC
^f University of Texas Southwestern Medical Center, Dallas, TX
^g St Luke's Health System, Kansas MO
^h University of Michigan Medical School, Ann Arbor, MI
ⁱ Eli Lilly and Company, Indiannapolis, IN
^j Parkland Health and Hospital System, Dallas, TX

^⁎Reprint requests: Christopher B Granger, MD , Duke Clinical Research Institute, 200 Morris Street, Durham, NC, 27701Duke Clinical Research Institute200 Morris StreetDurhamNC27701

Abstract

Several medications that are proven to reduce cardiovascular events exist for individuals with type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease, however they are substantially underused in clinical practice. Clinician, patient, and system-level barriers all contribute to these gaps in care; yet, there is a paucity of high quality, rigorous studies evaluating the role of interventions to increase utilization. The COORDINATE-Diabetes trial randomized 42 cardiology clinics across the United States to either a multifaceted, site-specific intervention focused on evidence-based care for patients with T2DM or standard of care. The multifaceted intervention comprised the development of an interdisciplinary care pathway for each clinic, audit-and-feedback tools and educational outreach, in addition to patient-facing tools. The primary outcome is the proportion of individuals with T2DM prescribed three key classes of evidence-based medications (high-intensity statin, angiotensin converting enzyme inhibitor or angiotensin receptor blocker, and either a sodium/glucose cotransporter-2 inhibitor (SGLT-2i) inhibitor or glucagon-like peptide 1 receptor agonist (GLP-1RA) and will be assessed at least 6 months after participant enrollment. COORDINATE-Diabetes aims to identify strategies that improve the implementation and adoption of evidence-based therapies.

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Vol 256

P. 2-12 - février 2023 Retour au numéro

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Coordinating Cardiology clinics randomized trial of interventions to improve outcomes (COORDINATE) – Diabetes: rationale and design - 12/01/23

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