Randomised controlled trial
Coordinated Care to Optimize Cardiovascular Preventive Therapies in Type 2 Diabetes
- Cluster randomised controlled trial
- 43 US cardiology clinics
Authors' conclusion
A coordinated, multifaceted intervention increased prescription of 3 groups of evidence-based therapies in adults with type 2 diabetes and atherosclerotic cardiovascular disease.
Study context
- Population
- Adults with T2DM and atherosclerotic CVD not already taking all 3 groups of evidence-based therapies
- Participants
- 1,049 adults
- Comparison
- Coordinated, multifaceted intervention vs usual care
- Interventionn = 459
- Usual caren = 590reference
- Primary endpoint
- Proportion prescribed all 3 groups of recommended therapies (high-intensity statins, ACEi or ARB, SGLT2 inhibitors and/or GLP-1 receptor agonists)
- Follow-up
- 6 to 12 months after enrollment
Primary result
Prescribed all 3 therapies · last follow-up visit (12 months for 97.3%)
Adjusted odds ratio
4.38
95% CI 2.49–7.71
P < 0.001
Events by treatment group
Intervention vs Usual care
adjusted OR 4.38 (95% CI 2.49–7.71); P < 0.001
As reported in the abstract
Secondary outcomes
| Outcome | Intervention | Usual care | Estimate | |
|---|---|---|---|---|
| High-intensity statins prescribed (baseline to last follow-up) | 70.7% | 56.8% | adjusted OR 1.73 (95% CI 1.06–2.83) | |
| Baseline | 66.5% | 58.2% | ||
| ACEi or ARB prescribed (baseline to last follow-up) | 81.4% | 68.4% | adjusted OR 1.82 (95% CI 1.14–2.91) | |
| Baseline | 75.1% | 69.6% | ||
| SGLT2 inhibitors and/or GLP-1 receptor agonists prescribed (baseline to last follow-up) | 60.4% | 35.5% | adjusted OR 3.11 (95% CI 2.08–4.64) | |
| Baseline | 12.3% | 14.5% | ||
| Composite of all-cause death or hospitalization for MI, stroke, decompensated HF or urgent revascularization · trial not powered to show these differences | 5% | 6.8% | adjusted HR 0.79 (95% CI 0.46–1.33) | |
| 0.20.5125Ratio (log scale) |
Atherosclerotic CVD risk factors
- Intervention not associated with changes in risk factors
Original publication
Coordinated Care to Optimize Cardiovascular Preventive Therapies in Type 2 Diabetes. JAMA. Published 18 April 2023. doi:10.1001/jama.2023.2854
Summarised from the published abstract; every number is checked against it