Clinical utility of a novel test for assessing cardiovascular disease risk in type 2 diabetes: a randomized controlled trial

Diabetology & Metabolic Syndrome

Research

David Paculdo¹  Isabella Cooney¹  Enrico de Belen¹  Divya Ganesan¹  John W. Peabody²  Nelson Trujillo³ 

[1] QURE Healthcare, 450 Pacific Ave., Suite 200, 94133, San Francisco, CA, USA;QURE Healthcare, 450 Pacific Ave., Suite 200, 94133, San Francisco, CA, USA;University of California, San Francisco, 550 16th Street, Third Floor, San Francisco, CA, USA;University of California, Los Angeles, 650 Charles E. Young Dr S, Los Angeles, CA, USA;SomaLogic Operating Co., Inc., 2945 Wilderness Pl., Boulder, CO, USA;Boulder Community Health, 4747 Arapahoe Ave., Boulder, CO, USA;

关键词: Primary care;    Cardiometabolic disease;    Polypharmacy;    Drug-drug interactions;    Medication nonadherence;    Disease progression;    Clinical utility;   

DOI  :  10.1186/s13098-023-01122-w

 received in 2023-03-16, accepted in 2023-06-23,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe risk for and treatment of cardiovascular disease (CVD) in type 2 diabetes (T2DM) is often incorrect and delayed. We wished to determine if a novel test improved physicians’ ability to risk stratify, diagnose, and treat patients with T2DM.MethodsIn a 2-phase randomized controlled trial comparing the clinical workup, diagnosis, and management of online, simulated patients with T2DM in a nationwide sample of cardiologists and primary care physicians, participants were randomly assigned to control or one of two intervention groups. Intervention participants had access to standard of care diagnostic tools plus a novel diagnostic CVD risk stratification test.ResultsIn control, there was no change in CV risk stratification of simulated patients between baseline and round 2 (37.1 to 38.3%, p = 0.778). Pre-post analysis showed significant improvements in risk stratification in both Intervention 1 (38.7 to 65.3%) and Intervention 2 (41.9 to 65.8%) (p < 0.01) compared to controls. Both intervention groups significantly increased prescribing SGLT2 inhibitors/GLP1 receptor agonists versus control, + 18.9% for Intervention 1 (p = 0.020) and 1 + 9.4% for Intervention 2 (p = 0.014). Non-pharmacologic treatment improved significantly compared to control (+ 30.0% in Intervention 1 (p < 0.001) and + 22.8% in Intervention 2 (p = 0.001). Finally, monitoring HgbA1C, blood pressure, and follow-up visit frequency improved by + 20.3% (p = 0.004) in Intervention 1 and + 29.8% (p < 0.001) in Intervention 2 compared with control.ConclusionUse of the novel test significantly improved CV risk stratification among T2DM patients. Statistically significant increases treatments were demonstrated, specifically SGLT2 inhibitors and GLP1 receptor antagonists and recommendations of evidence-based non-pharmacologic treatments.Trial registration ClinicalTrials.gov, NCT05237271

【 授权许可】

CC BY   
© The Author(s) 2023

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