Expanding Technology-Enabled, Nurse-Delivered Chronic Disease Care : A Pragmatic, Randomized, Effectiveness-Implementation Trial
Primary result · Mean change in HbA1c from 0 to 12 monthsResult — go to the resultMean between-group difference −0.4 percentage points 95% CI −1.0 to 0.3Authors' conclusion
Comprehensive telehealth did not substantially lower HbA1c relative to control in this study.
Study context
- Population
- Adults with T2D with hemoglobin A1c (HbA1c) persistently ≥8.0% for ≥6 months and hypertension (≥1 systolic blood pressure (BP) >140 mm Hg or diastolic BP >90 mm Hg in past year), 6 academic primary care or endocrinology clinics in an fee-for-service (FFS) environment; 64% female, 68% Black, mean age 54.5 years, mean HbA1c 9.8%
- Comparison
- Nurse-delivered comprehensive telehealth vs self-monitoring control
- Primary endpoint
- Change in HbA1c
- Follow-up
- 12 months
Methodological detailspragmatic, effectiveness-implementation, multicentre
- Pragmatic
- Effectiveness-implementation
- Multicentre
Primary result
Mean change in HbA1c from 0 to 12 months
Mean between-group difference
−0.4 percentage points
95% CI −1.0 to 0.3
Change by group
Comprehensive telehealth
−1.1
mean · percentage points
Self-monitoring
−0.7
mean · percentage points
Comprehensive telehealthvs Self-monitoring
mean between-group difference −0.4 percentage points (95% CI −1.0 to 0.3)
As reported in the abstract
Secondary outcomes
| Outcome | Between-group difference in change (CI) | |
|---|---|---|
| Diabetes self-care · 12 monthsFavoring comprehensive telehealth | 0.4 (0.0–0.9) | |
| −0.500.51Difference (linear scale) |
Secondary outcomes other than diabetes self-care · 12 months
- Between-group differences in change in secondary outcomes did not reach statistical significance
Implementation fidelity of the comprehensive program
- Comprehensive program delivered with suboptimal fidelity: median encounters per participant
- 9
- Fidelity threshold (encounters)
- ≥12
- Analyses identified barriers to program delivery
Original publication
Expanding Technology-Enabled, Nurse-Delivered Chronic Disease Care : A Pragmatic, Randomized, Effectiveness-Implementation Trial. Ann Intern Med. Published 23 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →