Browsing by Author "Kaufman, Brystana G"

Filter results by typing the first few letters
Now showing 1 - 3 of 3
  • Thumbnail Image
    ItemOpen Access
    EXpanding Technology-Enabled, Nurse-Delivered Chronic Disease Care (EXTEND): Protocol and Baseline Data for a Randomized Trial.
    (Contemporary clinical trials, 2024-08) German, Jashalynn; Yang, Qing; Hatch, Daniel; Lewinski, Allison; Bosworth, Hayden B; Kaufman, Brystana G; Chatterjee, Ranee; Pennington, Gina; Matters, Doreen; Lee, Donghwan; Urlichich, Diana; Kokosa, Sarah; Canupp, Holly; Gregory, Patrick; Roberson, Cindy Leslie; Smith, Benjamin; Huber, Sherry; Doukellis, Katheryn; Deal, Tammi; Burns, Rose; Crowley, Matthew J; Shaw, Ryan J

    Background

    Approximately 10-15 % of individuals with type 2 diabetes have persistently poorly-controlled diabetes mellitus (PPDM) despite receiving available care, and frequently have comorbid hypertension. Mobile monitoring-enabled telehealth has the potential to improve outcomes in treatment-resistant chronic disease by supporting self-management and facilitating patient-clinician contact but must be designed in a manner amenable to real-world use.

    Methods

    Expanding Technology-Enabled, Nurse-Delivered Chronic Disease Care (EXTEND) is an ongoing randomized trial comparing two 12-month interventions for comorbid PPDM and hypertension: 1) EXTEND, a mobile monitoring-enabled self-management intervention; and 2) EXTEND Plus, a comprehensive, nurse-delivered telehealth program incorporating mobile monitoring, self-management support, and pharmacist-supported medication management. Both arms leverage a novel platform that uses existing technological infrastructure to enable transmission of patient-generated health data into the electronic health record. The primary study outcome is difference in HbA1c change from baseline to 12 months. Secondary outcomes include blood pressure, weight, implementation barriers/facilitators, and costs.

    Results

    Enrollment concluded in June 2023 following randomization of 220 patients. Baseline characteristics are similar between arms; mean age is 54.5 years, and the cohort is predominantly female (63.6 %) and Black (68.2 %), with a baseline HbA1c of 9.81 %.

    Conclusion

    The EXTEND trial is evaluating two mobile monitoring-enabled telehealth approaches that seek to improve outcomes for patients with PPDM and hypertension. Critically, these approaches are designed around existing infrastructure, so may be amenable to implementation and scaling. This study will promote real-world use of telehealth to maximize benefits for those with high-risk chronic disease.
  • Thumbnail Image
    ItemOpen Access
    Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial.
    (Implementation science communications, 2023-10) Webb, Sara; Drake, Connor; Coffman, Cynthia J; Sullivan, Caitlin; Sperber, Nina; Tucker, Matthew; Zullig, Leah L; Hughes, Jaime M; Kaufman, Brystana G; Pura, John A; Anderson, Livia; Hastings, Susan N; Van Houtven, Courtney H; Abbate, Lauren M; Hoenig, Helen; Ballengee, Lindsay A; Wang, Virginia; Allen, Kelli D

    Background

    Knee osteoarthritis (OA) is a leading cause of chronic pain and disability and one of the most common conditions treated in outpatient physical therapy (PT). Because of the high and growing prevalence of knee OA, there is a need for efficient approaches for delivering exercise-based PT to patients with knee OA. A prior randomized controlled trial (RCT) showed that a 6-session Group Physical Therapy Program for Knee OA (Group PT) yields equivalent or greater improvements in pain and functional outcomes compared with traditional individual PT, while requiring fewer clinician hours per patient to deliver. This manuscript describes the protocol for a hybrid type III effectiveness-implementation trial comparing two implementation packages to support delivery of Group PT.

    Methods

    In this 12-month embedded trial, a minimum of 16 Veterans Affairs Medical Centers (VAMCs) will be randomized to receive one of two implementation support packages for their Group PT programs: a standard, low-touch support based on Replicating Effective Programs (REP) versus enhanced REP (enREP), which adds tailored, high-touch support if sites do not meet Group PT adoption and sustainment benchmarks at 6 and 9 months following launch. Implementation outcomes, including penetration (primary), adoption, and fidelity, will be assessed at 6 and 12 months (primary assessment time point). Additional analyses will include patient-level effectiveness outcomes (pain, function, satisfaction) and staffing and labor costs. A robust qualitative evaluation of site implementation context and experience, as well as site-led adaptations to the Group PT program, will be conducted.

    Discussion

    To our knowledge, this study is the first to evaluate the impact of tailored, high-touch implementation support on implementation outcomes when compared to standardized, low-touch support for delivering a PT-based intervention. The Group PT program has strong potential to become a standard offering for PT, improving function and pain-related outcomes for patients with knee OA. Results will provide information regarding the effectiveness and value of this implementation approach and a deeper understanding of how healthcare systems can support wide-scale adoption of Group PT.

    Trial registration

    This study was registered on March 7, 2022 at ClinicalTrials.gov (identifier NCT05282927 ).
  • Thumbnail Image
    ItemOpen Access
    Trends in Place of Death for Individuals With Cardiovascular Disease in the United States
    (Journal of the American College of Cardiology, 2019-10-15) Cross, Sarah H; Kaufman, Brystana G; Mentz, Robert J; Kamal, Arif H; Taylor, Donald H; Warraich, Haider J