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Published on: February 28, 2013

The Cholesterol, Hypertension, And Glucose Education (CHANGE) study: results from a randomized controlled trial in

Matthew J Crowley1, Benjamin J Powers, Maren K Olsen

  • 1Center for Health Services Research in Primary Care, Durham VAMC, Durham, NC, USA. matthew.crowley@dm.duke.edu

American Heart Journal
|July 3, 2013
PubMed

Insights

A nurse telephone intervention improved medication adherence in African Americans with type 2 diabetes but did not significantly lower cardiovascular disease risk factors like blood pressure or cholesterol.

Area of Science:

  • Public Health
  • Cardiology
  • Endocrinology

Background:

  • Cardiovascular disease (CVD) and diabetes contribute significantly to mortality disparities in African Americans.
  • Evaluating interventions to reduce CVD risk in this population is critical.

Purpose of the Study:

  • To assess the impact of a nurse telephone intervention on CVD risk factors in African Americans with type 2 diabetes.
  • To determine if the intervention improves systolic blood pressure (SBP), hemoglobin A1c (HbA1c), and low-density lipoprotein cholesterol (LDL-C).

Main Methods:

  • 359 African Americans with type 2 diabetes were randomized to usual care or a 12-month nurse telephone intervention.
  • Intervention included monthly self-management support and quarterly medication management.
  • Coprimary outcomes: changes in SBP, HbA1c, and LDL-C; secondary outcome: medication adherence.

Main Results:

  • No significant differences in SBP, HbA1c, or LDL-C between groups.
  • Intervention group showed significantly improved self-reported medication adherence (OR 4.4, P = .0008).
  • Improved adherence did not translate to better control of primary CVD risk factors.

Conclusions:

  • The nurse telephone intervention enhanced medication adherence but did not effectively reduce key CVD risk factors in African Americans with diabetes.
  • Further research is required to develop strategies that more effectively impact CVD risk in this demographic.
Abstract

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