Key result
A nurse-delivered comprehensive telehealth program resulted in a difference of -0.4 percentage points (95% CI, -1.0 to 0.3) compared to a self-monitoring control program at 12 months.
RCT
randomized
Yes
Answers are grounded in this paper and cite their sources.
Shows nurse-delivered telehealth does not significantly reduce HbA1c in patients with diabetes and hypertension, suggesting implementation barriers in fee-for-service care.
BACKGROUND: Comprehensive telehealth is used effectively for treatment-resistant chronic diseases in certain integrated health systems but has seldom been implemented in systems that provide mainly fee-for-service (FFS) care. OBJECTIVE: To examine the effectiveness and implementation of comprehensive telehealth delivered in an FFS environment for patients with uncontrolled type 2 diabetes (T2D) and comorbid hypertension. DESIGN: Pragmatic, randomized, effectiveness-implementation trial. (ClinicalTrials.gov: NCT05120544). SETTING: 6 academic primary care or endocrinology clinics. PARTICIPANTS: ) persistently at 8.0% or higher for at least 6 months and hypertension with at least 1 systolic blood pressure (BP) above 140 mm Hg or diastolic BP above 90 mm Hg in the past year. INTERVENTION: Two 12-month, mobile monitoring-enabled interventions: a self-monitoring control program and a nurse-delivered, comprehensive telehealth program incorporating self-management support and medication management. MEASUREMENTS: ) and secondary outcomes were evaluated at 12 months. Implementation analyses evaluated fidelity and barriers to intervention delivery. RESULTS: change at 12 months was -0.4 percentage points (95% CI, -1.0 to 0.3 percentage points). Between-group differences in change in secondary outcomes did not reach statistical significance, except for diabetes self-care (0.4 [CI, 0.0 to 0.9], favoring comprehensive telehealth). The comprehensive program was delivered with suboptimal fidelity (median encounters per participant, 9; fidelity threshold, ≥12); analyses identified barriers to program delivery. LIMITATION: Generalizability to dissimilar populations and systems lacking telehealth infrastructure may be limited. CONCLUSION: relative to control in this study. Population factors, intervention and control program design, and barriers to FFS implementation of comprehensive telehealth may have contributed to these findings. PRIMARY FUNDING SOURCE: National Institute of Nursing Research and Duke Clinical & Translational Science Institute.
No takes yet. Share an insight, caveat, or question.
Crowley et al. (2026) conducted an RCT in uncontrolled type 2 diabetes (T2D) and comorbid hypertension. nurse-delivered, comprehensive telehealth program vs. self-monitoring control program was evaluated (MD -0.4 percentage points, 95% CI -1.0 to 0.3). A nurse-delivered comprehensive telehealth program resulted in a difference of -0.4 percentage points (95% CI, -1.0 to 0.3) compared to a self-monitoring control program at 12 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: