■COORDINATE-Diabetes试验的结果表明,基于临床的干预增加了对2型糖尿病和动脉粥样硬化性心血管疾病参与者的循证医学治疗处方.这项次要分析评估了干预成功率在不同性别之间是否一致,种族,和种族。
■协调-糖尿病,整群随机试验,招募了来自43个美国心脏病学诊所的参与者(20名随机接受干预治疗,23名随机接受常规治疗).主要结局是所有3组循证治疗的参与者比例(高强度他汀类药物,血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂,和钠-葡萄糖协同转运蛋白-2抑制剂或胰高血糖素样肽1受体激动剂)在最后一次试验评估(6至12个月)。在这个预设的分析中,混合效应逻辑回归模型用于通过自我报告的性别评估结果,种族,干预和常规护理组的种族,随着基线特征的调整,药物,合并症,和网站位置。
■在1045名患有2型糖尿病和动脉粥样硬化性心血管疾病的参与者中,平均年龄是70岁,32%是女性,16%是黑人,9%是西班牙裔。在最后一次审判评估中,在女性中规定所有3组循证治疗的参与者比例绝对增加(36%对15%),黑人参与者(41%对18%),与常规护理相比,西班牙裔参与者(46%对18%)接受干预,在不同性别之间具有一致的益处(男性与女性;Pinteraction=0.44),种族(黑白;Pinteraction=0.59),和种族(西班牙裔与非西班牙裔;Pinteraction=0.78)。
■COORDINATE-糖尿病干预成功改善了循证护理的提供,不管性别,种族,或种族。这种干预措施的广泛传播可以提高公平的医疗保健质量,特别是在妇女和少数族裔社区中,她们在临床试验中的代表性往往不足。
■URL:https://clinicaltrials.gov.唯一标识符:NCT03936660。
UNASSIGNED: Results from the COORDINATE-
Diabetes trial demonstrated that a multifaceted, clinic-based intervention increased prescription of evidence-based medical therapies to participants with type 2
diabetes and atherosclerotic cardiovascular disease. This secondary analysis assessed whether intervention success was consistent across sex, race, and ethnicity.
UNASSIGNED: COORDINATE-
Diabetes, a cluster randomized
trial, recruited participants from 43 US cardiology clinics (20 randomized to intervention and 23 randomized to usual care). The primary outcome was the proportion of participants prescribed all 3 groups of evidence-based therapy (high-intensity statin, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, and sodium-glucose cotransporter-2 inhibitor or glucagon-like peptide 1 receptor agonist) at last
trial assessment (6 to 12 months). In this prespecified analysis, mixed-effects logistic regression models were used to assess the outcome by self-reported sex, race, and ethnicity in the intervention and usual care groups, with adjustment for baseline characteristics, medications, comorbidities, and site location.
UNASSIGNED: Among 1045 participants with type 2 diabetes and atherosclerotic cardiovascular disease, the median age was 70 years, 32% were female, 16% were Black, and 9% were Hispanic. At the last
trial assessment, there was an absolute increase in the proportion of participants prescribed all 3 groups of evidence-based therapy in women (36% versus 15%), Black participants (41% versus 18%), and Hispanic participants (46% versus 18%) with the intervention compared with usual care, with consistent benefit across sex (male versus female; Pinteraction=0.44), race (Black versus White; Pinteraction=0.59), and ethnicity (Hispanic versus Non-Hispanic; Pinteraction= 0.78).
UNASSIGNED: The COORDINATE-Diabetes intervention successfully improved delivery of evidence-based care, regardless of sex, race, or ethnicity. Widespread dissemination of this intervention could improve equitable health care quality, particularly among women and minority communities who are frequently underrepresented in clinical trials.
UNASSIGNED: URL: https://clinicaltrials.gov. Unique identifier: NCT03936660.