This project is studying whether a team-based specialty clinic can help people with type 2 diabetes and heart disease better manage their blood pressure and cholesterol. The clinic includes coordinated care from heart doctors, kidney doctors, diabetes specialists, and liver doctors. The study will compare two groups of patients: one receiving usual care from their primary care provider, and one referred to the Duke Cardiometabolic Prevention Clinic for multidisciplinary care. The main goals are to find out if this clinic improves blood pressure and cholesterol control over 12 months, increases use of recommended heart medications, and reduces hospital visits and other healthcare use. Participants will be randomly assigned to one of the two groups. Those referred to the clinic will: 1) Meet with a cardiologist for an initial evaluation. 2) Be referred to other specialists (such as endocrinology, nephrology, or hepatology) based on their needs. 3) Receive ongoing, coordinated care from a team of specialists working together to improve their heart and metabolic health.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
150
Patients who are referred to the cardiometabolic prevention clinic within the intervention arm will be evaluated first by a cardiology provider (as each patient has a history of ASCVD). On this initial visit, the cardiology provider will assess the patient's risk factor profile - to identify the presence of co-morbid conditions or uncontrolled risk factors. The need for additional referrals to other clinicians within the cardiometabolic clinic will specifically outlined criteria. These referrals will be offered to the patient and facilitated after the first visit. Preventive care will follow routine, evidence-based care. Clinicians within the cardiometabolic prevention clinic will meet bi-weekly to discuss enrolled patients, thus every individual in the intervention arm will receive coordinated, multi-specialty care.
Duke University Medical Center
Durham, North Carolina, United States
RECRUITINGChange in LDL-C
Change in low-density-lipoprotein cholesterol from baseline
Time frame: Baseline, 12 months after enrollment
Change in Systolic Blood Pressure
Change in systolic blood pressure from baseline
Time frame: Baseline, 12 months after enrollment
Number of participants meeting Risk Factor Targets
Those achieving both of the following, and of attaining each component individually: systolic blood pressure (sBP) \< 130 and low-density-lipoprotein (LDL) \< 70mg/dL
Time frame: 12 months after enrollment
Change in Number of participants on Evidence-Based Medication Targets
Evidence-based medications include (where appropriate) ACE/ARB/ARNI, high-intensity statin, SGLT2i or GLP-1 RA.
Time frame: Baseline, 12 months after enrollment
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.