Principal Investigator: David H. Gustafson, PhD and Jane Mahoney, MD
DFMCH Investigator: Randy Brown, MD, PhD
Summary of Study:
The primary purpose of this study is to conduct a RCT to examine the effects of C-CHESS, a web-based intervention, on health outcomes and healthcare use among older adults with 3 or all of the following 5 chronic conditions: diabetes, high blood pressure, high cholesterol, arthritis and obesity. Patients in the experimental group will receive treatment as usual (TAU) plus C-CHESS. Patients in the comparison group will receive TAU+internet and links to helpful websites. We will give laptops and provide Internet access to those who do not already have it. Patients will be tracked for a total of 18 months–12 with access to the interventions and 6 months for follow up, with data collected every 6 months.
The study focuses on inspiring and improving the health and well-being of older adults with MCC. MCCs are common and expensive among patients aged ≥65 and are associated with lower quality of life, poorer response to treatment, worse medical and psychiatric outcomes, higher mortality, and higher costs of care. Treatment of MCCs focuses on medical care, but patient self-management and loneliness matter too. Numerous studies indicate that chronic conditions contribute to loneliness and loneliness in turn contributes to reduced functionality and chronic illness.
Eligibility and Exclusion of Recruitment
Patients are eligible for the study if they:
- Are ≥65 years old
- Have been treated in the clinic for at least the previous 18 months with no plans to leave during the study period
- Have ≥3 of the following chronic conditions:
- BMI ≥30
- Report no current psychotic disorder that would prevent participation
- Have no acute medical problem requiring immediate hospitalization
- Be able to read and sign the consent form in English
- Have no known terminal illness; and
- Are willing to share health-related study data
Questions of Research
This is a randomized clinical trial that will test the following hypotheses:
- Primary outcomes: Patients assigned to TAU+C-CHESS will have better quality of life and less primary care use (fewer visits) than those assigned to TAU+Internet.
- Secondary outcomes: Patients assigned to TAU+C-CHESS will have improved composite scores of health; improved individual condition outcomes (mm Hg for hypertension, mg/dL for hyperlipidemia (LDL), HbA1c for diabetes, and pain for arthritis); and fewer symptoms than patients assigned to TAU+Internet.
- Mediators: Patients assigned to TAU+C-CHESS will have, compared with patients assigned to TAU+Internet, greater adherence to medications and appointments as well as improved competence, relatedness, and autonomy.
- Moderators: Improvements in primary outcomes for TAU+C-CHESS vs. TAU+Internet will be greater for women than men, those ≥ 75 vs. 65 to 74, and those with ≥5 chronic conditions vs. 3-4.
Study Contact Person: Gina Landucci
Date of Approval: June 23, 2017