The Cholesterol, Hypertension, And Glucose Education (CHANGE) study: results from a randomized controlled trial in African Americans with diabetes.
| dc.contributor.author | Crowley, Matthew J | |
| dc.contributor.author | Powers, Benjamin J | |
| dc.contributor.author | Olsen, Maren K | |
| dc.contributor.author | Grubber, Janet M | |
| dc.contributor.author | Koropchak, Celine | |
| dc.contributor.author | Rose, Cynthia M | |
| dc.contributor.author | Gentry, Pamela | |
| dc.contributor.author | Bowlby, Lynn | |
| dc.contributor.author | Trujillo, Gloria | |
| dc.contributor.author | Maciejewski, Matthew L | |
| dc.contributor.author | Bosworth, Hayden B | |
| dc.date.accessioned | 2024-02-01T16:36:37Z | |
| dc.date.available | 2024-02-01T16:36:37Z | |
| dc.date.issued | 2013-07 | |
| dc.description.abstract | BackgroundCardiovascular disease (CVD) and diabetes account for one-third of the mortality difference between African American and white patients. We evaluated the effect of a CVD risk reduction intervention in African Americans with diabetes.MethodsWe randomized 359 African Americans with type 2 diabetes to receive usual care or a nurse telephone intervention. The 12-month intervention provided monthly self-management support and quarterly medication management facilitation. Coprimary outcomes were changes in systolic blood pressure (SBP), hemoglobin A1c (HbA1c), and low-density lipoprotein cholesterol (LDL-C) over 12 months. We estimated between-intervention group differences over time using linear mixed-effects models. The secondary outcome was self-reported medication adherence.ResultsThe sample was 72% female; 49% had low health literacy, and 37% had annual income <$10,000. Model-based estimates for mean baseline SBP, HbA1c, and LDL-C were 136.8 mm Hg (95% CI 135.0-138.6), 8.0% (95% CI 7.8-8.2), and 99.1 mg/dL (95% CI 94.7-103.5), respectively. Intervention patients received 9.9 (SD 3.0) intervention calls on average. Primary providers replied to 76% of nurse medication management facilitation contacts, 18% of these resulted in medication changes. There were no between-group differences over time for SBP (P = .11), HbA1c (P = .66), or LDL-C (P = .79). Intervention patients were more likely than those receiving usual care to report improved medication adherence (odds ratio 4.4, 95% CI 1.8-10.6, P = .0008), but adherent patients did not exhibit relative improvement in primary outcomes.ConclusionsThis intervention improved self-reported medication adherence but not CVD risk factor control among African Americans with diabetes. Further research is needed to determine how to maximally impact CVD risk factors in African American patients. | |
| dc.identifier | S0002-8703(13)00286-X | |
| dc.identifier.issn | 0002-8703 | |
| dc.identifier.issn | 1097-6744 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Elsevier BV | |
| dc.relation.ispartof | American heart journal | |
| dc.relation.isversionof | 10.1016/j.ahj.2013.04.004 | |
| dc.rights.uri | ||
| dc.subject | Humans | |
| dc.subject | Hypertension | |
| dc.subject | Diabetes Mellitus, Type 2 | |
| dc.subject | Cholesterol | |
| dc.subject | Blood Glucose | |
| dc.subject | Self Care | |
| dc.subject | Prevalence | |
| dc.subject | Survival Rate | |
| dc.subject | Follow-Up Studies | |
| dc.subject | Blood Pressure | |
| dc.subject | Middle Aged | |
| dc.subject | Disease Management | |
| dc.subject | United States | |
| dc.subject | Female | |
| dc.subject | Male | |
| dc.subject | Patient Education as Topic | |
| dc.subject | Black or African American | |
| dc.subject | Glycated Hemoglobin | |
| dc.title | The Cholesterol, Hypertension, And Glucose Education (CHANGE) study: results from a randomized controlled trial in African Americans with diabetes. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Crowley, Matthew J|0000-0002-6205-4536 | |
| duke.contributor.orcid | Olsen, Maren K|0000-0002-9540-2103 | |
| duke.contributor.orcid | Maciejewski, Matthew L|0000-0003-1765-5938 | |
| duke.contributor.orcid | Bosworth, Hayden B|0000-0001-6188-9825 | |
| pubs.begin-page | 179 | |
| pubs.end-page | 186 | |
| pubs.issue | 1 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Faculty | |
| pubs.organisational-group | Basic Science Departments | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Biostatistics & Bioinformatics | |
| pubs.organisational-group | Medicine | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences | |
| pubs.organisational-group | Medicine, Endocrinology, Metabolism, and Nutrition | |
| pubs.organisational-group | Medicine, General Internal Medicine | |
| pubs.organisational-group | Duke Cancer Institute | |
| pubs.organisational-group | Duke Clinical Research Institute | |
| pubs.organisational-group | Institutes and Provost's Academic Units | |
| pubs.organisational-group | Center for the Study of Aging and Human Development | |
| pubs.organisational-group | Initiatives | |
| pubs.organisational-group | Duke Science & Society | |
| pubs.organisational-group | Population Health Sciences | |
| pubs.organisational-group | Duke Innovation & Entrepreneurship | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences | |
| pubs.organisational-group | Duke - Margolis Center For Health Policy | |
| pubs.organisational-group | Biostatistics & Bioinformatics, Division of Biostatistics | |
| pubs.publication-status | Published | |
| pubs.volume | 166 |
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