%0 Randomized Controlled Trial
%T Methods, rationale, and design for a remote pharmacist and navigator-driven disease management program to improve guideline-directed medical therapy in patients with type 2 diabetes at elevated cardiovascular and/or kidney risk.
%A Blood AJ
%A Chang LS
%A Colling C
%A Stern G
%A Gabovitch D
%A Feldman G
%A Adan A
%A Waterman F
%A Durden E
%A Hamersky C
%A Noone J
%A Aronson SJ
%A Liberatore P
%A Gaziano TA
%A Matta LS
%A Plutzky J
%A Cannon CP
%A Wexler DJ
%A Scirica BM
%J Prim Care Diabetes
%V 18
%N 2
%D 2024 04 31
%M 38302335
%F 2.567
%R 10.1016/j.pcd.2024.01.005
%X Describe the rationale for and design of Diabetes Remote Intervention to improVe use of Evidence-based medications (DRIVE), a remote medication management program designed to initiate and titrate guideline-directed medical therapy (GDMT) in patients with type 2 diabetes (T2D) at elevated cardiovascular (CV) and/or kidney risk by leveraging non-physician providers.<BR>An electronic health record based algorithm is used to identify patients with T2D and either established atherosclerotic CV disease (ASCVD), high risk for ASCVD, chronic kidney disease, and/or heart failure within our health system. Patients are invited to participate and randomly assigned to either simultaneous education and medication management, or a period of education prior to medication management. Patient navigators (trained, non-licensed staff) are the primary points of contact while a pharmacist or nurse practitioner reviews and authorizes each medication initiation and titration under an institution-approved collaborative drug therapy management protocol with supervision from a cardiologist and/or endocrinologist. Patient engagement is managed through software to support communication, automation, workflow, and standardization.<BR>We are testing a remote, navigator-driven, pharmacist-led, and physician-overseen management strategy to optimize GDMT for T2D as a population-level strategy to close the gap between guidelines and clinical practice for patients with T2D at elevated CV and/or kidney risk.