<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03821662</url>
  </required_header>
  <id_info>
    <org_study_id>00009334</org_study_id>
    <nct_id>NCT03821662</nct_id>
  </id_info>
  <brief_title>OT-Led Interdisciplinary Diabetes Self-Management Prgm</brief_title>
  <official_title>Occupational Therapy Led Interdisciplinary Diabetes Self-Management Program</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Arizona State University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Hand Therapy Partners</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Arizona State University</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      This study proposes to introduce an outpatient Occupational Therapy (OT)-led diabetes&#xD;
      intervention program. OTs with training in diabetes self-management modules that address&#xD;
      physical, social, emotional, and systemic factors that influence health. Patients receiving&#xD;
      outpatient OT services for development of diabetes self-management skills will be seen for&#xD;
      approximately 8 forty five-minute to one-hour sessions over 6 months. OTs will communicate&#xD;
      with other interdisciplinary care team members using Electronic Health Record (EHR)&#xD;
      messaging, phone calls, and in-person communication as needed. There will be at minimum a&#xD;
      monthly consult meeting with a doctor of psychology (Psy D), registered dietitian (RD),&#xD;
      social worker (SW), and pharmacist (PharmD), and the primary care medical team will be&#xD;
      provided with monthly progress notes. The investigators hypothesize that participants&#xD;
      demonstrate improved blood sugar levels, improved ability to take medications as directed,&#xD;
      increases in overall sense of physical, mental, and social health, and positive changes in&#xD;
      their self-efficacy related to diabetes self-management. The investigators also hypothesize&#xD;
      that OT visits will be reimbursed by insurers more than 50% of all billed visits.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Effective interventions to support patients' diabetes management are urgently needed to&#xD;
      curtail the growing financial and human cost of diabetes. However, sustainable solutions to&#xD;
      this health challenge have been elusive due to the intrinsic and extrinsic barriers patients&#xD;
      face when attempting to incorporate necessary health behaviors into their daily routines&#xD;
      (e.g., dietary changes, physical activity, medication management, blood glucose monitoring,&#xD;
      and stress management). The focus of occupational therapy (OT) is to work with patients&#xD;
      within the context of their daily lives. OTs identify current patient roles (work, family,&#xD;
      community), habits, and routines, then work with the patient to identify and address barriers&#xD;
      to diabetes self-management within these aspects of their daily lives. Within OT, an&#xD;
      intervention approach informed by Lifestyle Redesign (LR) has been shown to be effective at&#xD;
      improving diabetes-related health outcomes among people with diabetes. This study proposes to&#xD;
      introduce an OT- led diabetes intervention program into an outpatient OT clinic. The&#xD;
      intervention is an interdisciplinary team approach as the intervention is informed and&#xD;
      monitored by the interdisciplinary team members, who are part of the planning process, and&#xD;
      who will participate in regular review of the intervention and the patient needs. With OT&#xD;
      leading the team to address barriers to lifestyle modification, the primary care medical team&#xD;
      will continue to oversee the overall health care of the patient. The OT will communicate&#xD;
      regularly with the primary care team.&#xD;
&#xD;
      OTs with training in diabetes education will deliver the intervention to patients in the&#xD;
      study within the course of their typical work day at the OT clinic. Treatment activities and&#xD;
      materials will be delivered in English or Spanish, per patient preference as one of the OT&#xD;
      interventionists is fluent in Spanish. Patients receiving OT services for development of&#xD;
      diabetes self-management skills will be seen for approximately 8 forty five-minute to&#xD;
      one-hour sessions over 6 months. OT notes will be maintained within the Electronic Health&#xD;
      Record (EHR) as is standard practice at this clinic; the therapist will communicate with&#xD;
      other interdisciplinary care team members using EHR messaging, phone calls, and in-person&#xD;
      communication as needed. There will be at minimum a monthly consult meeting with a doctor of&#xD;
      psychology (Psy D), registered dietitian (RD), social worker (SW), and pharmacist (PharmD),&#xD;
      and the primary care medical team will be provided with monthly progress notes.&#xD;
&#xD;
      The intervention will be offered in a one-on-one direct therapy format. The intervention will&#xD;
      focus on lifestyle modification strategies that will improve the patient's diabetes&#xD;
      self-management skills. The intervention is organized into five modules that address:&#xD;
&#xD;
        -  living with diabetes,&#xD;
&#xD;
        -  strategies to communicate with healthcare providers to ensure patient needs are met,&#xD;
&#xD;
        -  analyzing and modifying patient habits and routines to determine what changes they must&#xD;
           make to manage their diabetes,&#xD;
&#xD;
        -  identify and use social supports to help manage diabetes&#xD;
&#xD;
        -  strategies to reduce stress and depression, improve emotional well-being, and minimize&#xD;
           risk of diabetes burn-out (patient frustration with living with the disease)&#xD;
&#xD;
      Each patient receives an individually tailored combination of modules, and treatment&#xD;
      activities within each module as established through collaborative goal setting between the&#xD;
      patient and OT during the initial evaluation.&#xD;
&#xD;
      The investigators will analyze outcomes using descriptive analytics and paired t-tests to&#xD;
      test our hypotheses. The investigators will collect EHR data on HbA1c and compare pre/post&#xD;
      measures of the clinically relevant self-report surveys on diabetes self care, and barriers&#xD;
      to self-care and management (Diabetes Empowerment Scale, Medication Adherence Assessment&#xD;
      Scale, and the Canadian Occupational Performance Measure), physical, mental, and social&#xD;
      health (Patient-Reported Outcomes Measurement Information System® PROMIS-29). Changes in&#xD;
      HbA1c levels will be tracked by obtaining recent levels from the patient's primary care team.&#xD;
      With patients referred to the OT intervention who have not had an HbA1c within ≤4 weeks of&#xD;
      the initial referral date, the OT will consult with the primary care physician and determine&#xD;
      if an HbA1c level can be obtained as a part of their normal care. The investigators will&#xD;
      collect EHR data on follow-up HbA1c testing scores that are available within 12 weeks of the&#xD;
      8th OT visit and self-report surveys the day of 8th OT visit. If a patient has completed the&#xD;
      full intervention, the study staff will follow-up biweekly for no more than 3 months after&#xD;
      their initial visit, and attempt to collect self-report data up to 6 months after the final&#xD;
      visit to determine the sustainability of outcomes.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">April 11, 2019</start_date>
  <completion_date type="Actual">July 30, 2019</completion_date>
  <primary_completion_date type="Actual">July 30, 2019</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>N/A</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Change from Baseline Glycated hemoglobin (HbA1C)</measure>
    <time_frame>Baseline &amp; 6 months.</time_frame>
    <description>Measure of blood glucose concentration over approximately the previous 12 weeks.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Canadian Occupational Therapy Measure (COPM)</measure>
    <time_frame>Baseline &amp; 6 months.</time_frame>
    <description>The Canadian Occupational Performance Measure is an evidence-based outcome measure designed to capture a client's self-perception of performance in everyday living, over time. Areas of everyday living explored during the interview include self-care, productivity or leisure. The client is asked to rate the importance of each of the occupations to his/her life using a 10-point rating scale. Once the top five most important occupations are identified, the client is asked to use a 10 point scale to rate their own level of performance and satisfaction with performance for each of the five identified problems. The therapist calculates an average COPM performance score and satisfaction score. These typically range between 1 and 10, where 1 indicates poor performance and low satisfaction, respectively, while 10 indicates very good performance and high satisfaction.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change from Baseline Patient-Reported Outcomes Measurement Information SystemⓇ (PROMIS) 29</measure>
    <time_frame>Baseline &amp; 6 months.</time_frame>
    <description>29-item quality of life survey of self-reported physical, mental and social health and wellbeing. The seven 4-item subscales are comprised of 5-point Likert Scale questions. The subscales can be administered together or individually. There is also one 11-point rating scale for pain intensity. The total raw score is the sum the values of the response to each question. For the 4-item subscales the range of raw scores is 4-20. T-scores can be calculated by the PROMIScore computer program with our without missing responses.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change from Baseline Diabetes Empowerment Scale (DES-SF)</measure>
    <time_frame>Baseline &amp; 6 months.</time_frame>
    <description>8-item measure of the psychosocial self-efficacy of people with diabetes. An item checked &quot;strongly agree&quot; receives 5 points; &quot;agree&quot; - 4 points; &quot;neutral&quot; - 3 points; &quot;disagree&quot; - 2 points; and &quot;strongly disagree&quot; receives 1 point. The numerical values for a set of items in a particular subscale (for example: items 5-14 in the &quot;Goal Setting&quot; subscale) are added and the total is divided by the number of items (in this case 10) in the subscale. The resulting value is the score for that subscale. An overall score for the DES can be calculated by adding all of the item scores and dividing by 28.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change from Baseline Medication Adherence Assessment Scale</measure>
    <time_frame>Baseline &amp; 6 months.</time_frame>
    <description>A 7-item survey of self-reported medication adherence. Total raw score is the sum of all likert scale items ranging from 0-28 total points. Lower scores indicate better adherence than higher scores. A score of zero indicates good adherence for self-management. Scores greater than 2 for any item indicate the need for intervention to address barriers to medication adherence.</description>
  </secondary_outcome>
  <number_of_arms>1</number_of_arms>
  <enrollment type="Actual">3</enrollment>
  <condition>Diabetes Mellitus, Type 2</condition>
  <condition>Diabetes Mellitus</condition>
  <arm_group>
    <arm_group_label>OT Diabetes Self-Management Intervention</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>The intervention is organized into five modules. Each participant receives an individually tailored combination of modules, and treatment activities within each module, as established through collaborative goal setting between the participant and OT during the initial evaluation. The five modules are: (1) Living with Diabetes-addressing gaps in the knowledge and skills necessary to effectively manage diabetes; (2) Access and Advocacy-strategies to collaborate and communicate with healthcare providers; (3) Activity and Health-analyzing daily habits and routines; (4) Social Support-strategies to address diabetes care in various social environments and to identify sources of support; (5) Emotional Well-Being-strategies to address stress, diabetes burnout, and depression.</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>OT Diabetes Self-Management Intervention</intervention_name>
    <description>Occupational therapy chronic disease self-management intervention.</description>
    <arm_group_label>OT Diabetes Self-Management Intervention</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Diagnosed with Diabetes Mellitus Type 2&#xD;
&#xD;
          -  Most recent HbA1c level &gt;7.0% OR has been identified by medical provider as having&#xD;
             uncontrolled diabetes&#xD;
&#xD;
          -  English or Spanish Speaking&#xD;
&#xD;
          -  Patient enrolled in a contracted commercial insurance plan or self-paying patients&#xD;
&#xD;
          -  Expresses willingness to make lifestyle changes related to diabetes self-care&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Patients that receive care through Workers Comp, or Motor Vehicle Insurance&#xD;
&#xD;
          -  Patients that do not speak English or Spanish&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Sue Dahl-Popolizio, DBH, OTR/L</last_name>
    <role>Principal Investigator</role>
    <affiliation>Arizona State University</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Hand Therapy Partners</name>
      <address>
        <city>Mesa</city>
        <state>Arizona</state>
        <zip>85298</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <reference>
    <citation>Clark., F A, Blanchard., J, Sleight, A., Cogan, A., Florindez, L., Gleason, S.,…Vigen, C. (2015). Lifestyle redesign: The intervention tested in the USC well elderly studies (2nd ed.). AOTA Press: MD</citation>
  </reference>
  <reference>
    <citation>Pyatak EA, Carandang K, Vigen CLP, Blanchard J, Diaz J, Concha-Chavez A, Sequeira PA, Wood JR, Whittemore R, Spruijt-Metz D, Peters AL. Occupational Therapy Intervention Improves Glycemic Control and Quality of Life Among Young Adults With Diabetes: the Resilient, Empowered, Active Living with Diabetes (REAL Diabetes) Randomized Controlled Trial. Diabetes Care. 2018 Apr;41(4):696-704. doi: 10.2337/dc17-1634. Epub 2018 Jan 19.</citation>
    <PMID>29351961</PMID>
  </reference>
  <verification_date>June 2020</verification_date>
  <study_first_submitted>January 24, 2019</study_first_submitted>
  <study_first_submitted_qc>January 28, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">January 30, 2019</study_first_posted>
  <last_update_submitted>June 8, 2020</last_update_submitted>
  <last_update_submitted_qc>June 8, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">June 9, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Diabetes</keyword>
  <keyword>Occupational Therapy</keyword>
  <keyword>Interdisciplinary Teams</keyword>
  <keyword>Diabetes Self-Management Education (DSME)</keyword>
  <keyword>Diabetes Self-Management</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Diabetes Mellitus</mesh_term>
    <mesh_term>Diabetes Mellitus, Type 2</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03821662
org study id: 00009334
nct id: NCT03821662
lead sponsor: 
collaborator: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
This study proposes to introduce an outpatient Occupational Therapy (OT)-led diabetes
      intervention program. OTs with training in diabetes self-management modules that address
      physical, social, emotional, and systemic factors that influence health. Patients receiving
      outpatient OT services for development of diabetes self-management skills will be seen for
      approximately 8 forty five-minute to one-hour sessions over 6 months. OTs will communicate
      with other interdisciplinary care team members using Electronic Health Record (EHR)
      messaging, phone calls, and in-person communication as needed. There will be at minimum a
      monthly consult meeting with a doctor of psychology (Psy D), registered dietitian (RD),
      social worker (SW), and pharmacist (PharmD), and the primary care medical team will be
      provided with monthly progress notes. The investigators hypothesize that participants
      demonstrate improved blood sugar levels, improved ability to take medications as directed,
      increases in overall sense of physical, mental, and social health, and positive changes in
      their self-efficacy related to diabetes self-management. The investigators also hypothesize
      that OT visits will be reimbursed by insurers more than 50% of all billed visits.
Effective interventions to support patients' diabetes management are urgently needed to
      curtail the growing financial and human cost of diabetes. However, sustainable solutions to
      this health challenge have been elusive due to the intrinsic and extrinsic barriers patients
      face when attempting to incorporate necessary health behaviors into their daily routines
      (e.g., dietary changes, physical activity, medication management, blood glucose monitoring,
      and stress management). The focus of occupational therapy (OT) is to work with patients
      within the context of their daily lives. OTs identify current patient roles (work, family,
      community), habits, and routines, then work with the patient to identify and address barriers
      to diabetes self-management within these aspects of their daily lives. Within OT, an
      intervention approach informed by Lifestyle Redesign (LR) has been shown to be effective at
      improving diabetes-related health outcomes among people with diabetes. This study proposes to
      introduce an OT- led diabetes intervention program into an outpatient OT clinic. The
      intervention is an interdisciplinary team approach as the intervention is informed and
      monitored by the interdisciplinary team members, who are part of the planning process, and
      who will participate in regular review of the intervention and the patient needs. With OT
      leading the team to address barriers to lifestyle modification, the primary care medical team
      will continue to oversee the overall health care of the patient. The OT will communicate
      regularly with the primary care team.

      OTs with training in diabetes education will deliver the intervention to patients in the
      study within the course of their typical work day at the OT clinic. Treatment activities and
      materials will be delivered in English or Spanish, per patient preference as one of the OT
      interventionists is fluent in Spanish. Patients receiving OT services for development of
      diabetes self-management skills will be seen for approximately 8 forty five-minute to
      one-hour sessions over 6 months. OT notes will be maintained within the Electronic Health
      Record (EHR) as is standard practice at this clinic; the therapist will communicate with
      other interdisciplinary care team members using EHR messaging, phone calls, and in-person
      communication as needed. There will be at minimum a monthly consult meeting with a doctor of
      psychology (Psy D), registered dietitian (RD), social worker (SW), and pharmacist (PharmD),
      and the primary care medical team will be provided with monthly progress notes.

      The intervention will be offered in a one-on-one direct therapy format. The intervention will
      focus on lifestyle modification strategies that will improve the patient's diabetes
      self-management skills. The intervention is organized into five modules that address:

        -  living with diabetes,

        -  strategies to communicate with healthcare providers to ensure patient needs are met,

        -  analyzing and modifying patient habits and routines to determine what changes they must
           make to manage their diabetes,

        -  identify and use social supports to help manage diabetes

        -  strategies to reduce stress and depression, improve emotional well-being, and minimize
           risk of diabetes burn-out (patient frustration with living with the disease)

      Each patient receives an individually tailored combination of modules, and treatment
      activities within each module as established through collaborative goal setting between the
      patient and OT during the initial evaluation.

      The investigators will analyze outcomes using descriptive analytics and paired t-tests to
      test our hypotheses. The investigators will collect EHR data on HbA1c and compare pre/post
      measures of the clinically relevant self-report surveys on diabetes self care, and barriers
      to self-care and management (Diabetes Empowerment Scale, Medication Adherence Assessment
      Scale, and the Canadian Occupational Performance Measure), physical, mental, and social
      health (Patient-Reported Outcomes Measurement Information System® PROMIS-29). Changes in
      HbA1c levels will be tracked by obtaining recent levels from the patient's primary care team.
      With patients referred to the OT intervention who have not had an HbA1c within ≤4 weeks of
      the initial referral date, the OT will consult with the primary care physician and determine
      if an HbA1c level can be obtained as a part of their normal care. The investigators will
      collect EHR data on follow-up HbA1c testing scores that are available within 12 weeks of the
      8th OT visit and self-report surveys the day of 8th OT visit. If a patient has completed the
      full intervention, the study staff will follow-up biweekly for no more than 3 months after
      their initial visit, and attempt to collect self-report data up to 6 months after the final
      visit to determine the sustainability of outcomes.
allocation: N/A
intervention model: Single Group Assignment
primary purpose: Treatment
masking: None (Open Label)
measure: Change from Baseline Glycated hemoglobin (HbA1C)
time frame: Baseline & 6 months.
description: Measure of blood glucose concentration over approximately the previous 12 weeks.
measure: Canadian Occupational Therapy Measure (COPM)
time frame: Baseline & 6 months.
description: The Canadian Occupational Performance Measure is an evidence-based outcome measure designed to capture a client's self-perception of performance in everyday living, over time. Areas of everyday living explored during the interview include self-care, productivity or leisure. The client is asked to rate the importance of each of the occupations to his/her life using a 10-point rating scale. Once the top five most important occupations are identified, the client is asked to use a 10 point scale to rate their own level of performance and satisfaction with performance for each of the five identified problems. The therapist calculates an average COPM performance score and satisfaction score. These typically range between 1 and 10, where 1 indicates poor performance and low satisfaction, respectively, while 10 indicates very good performance and high satisfaction.
measure: Change from Baseline Patient-Reported Outcomes Measurement Information SystemⓇ (PROMIS) 29
time frame: Baseline & 6 months.
description: 29-item quality of life survey of self-reported physical, mental and social health and wellbeing. The seven 4-item subscales are comprised of 5-point Likert Scale questions. The subscales can be administered together or individually. There is also one 11-point rating scale for pain intensity. The total raw score is the sum the values of the response to each question. For the 4-item subscales the range of raw scores is 4-20. T-scores can be calculated by the PROMIScore computer program with our without missing responses.
measure: Change from Baseline Diabetes Empowerment Scale (DES-SF)
time frame: Baseline & 6 months.
description: 8-item measure of the psychosocial self-efficacy of people with diabetes. An item checked "strongly agree" receives 5 points; "agree" - 4 points; "neutral" - 3 points; "disagree" - 2 points; and "strongly disagree" receives 1 point. The numerical values for a set of items in a particular subscale (for example: items 5-14 in the "Goal Setting" subscale) are added and the total is divided by the number of items (in this case 10) in the subscale. The resulting value is the score for that subscale. An overall score for the DES can be calculated by adding all of the item scores and dividing by 28.
measure: Change from Baseline Medication Adherence Assessment Scale
time frame: Baseline & 6 months.
description: A 7-item survey of self-reported medication adherence. Total raw score is the sum of all likert scale items ranging from 0-28 total points. Lower scores indicate better adherence than higher scores. A score of zero indicates good adherence for self-management. Scores greater than 2 for any item indicate the need for intervention to address barriers to medication adherence.
arm group label: OT Diabetes Self-Management Intervention
arm group type: Experimental
description: The intervention is organized into five modules. Each participant receives an individually tailored combination of modules, and treatment activities within each module, as established through collaborative goal setting between the participant and OT during the initial evaluation. The five modules are: (1) Living with Diabetes-addressing gaps in the knowledge and skills necessary to effectively manage diabetes; (2) Access and Advocacy-strategies to collaborate and communicate with healthcare providers; (3) Activity and Health-analyzing daily habits and routines; (4) Social Support-strategies to address diabetes care in various social environments and to identify sources of support; (5) Emotional Well-Being-strategies to address stress, diabetes burnout, and depression.
intervention type: Behavioral
intervention name: OT Diabetes Self-Management Intervention
description: Occupational therapy chronic disease self-management intervention.
arm group label: OT Diabetes Self-Management Intervention
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Sue Dahl-Popolizio, DBH, OTR/L
role: Principal Investigator
affiliation: Arizona State University
facility: 
country: United States
citation: Clark., F A, Blanchard., J, Sleight, A., Cogan, A., Florindez, L., Gleason, S.,…Vigen, C. (2015). Lifestyle redesign: The intervention tested in the USC well elderly studies (2nd ed.). AOTA Press: MD
citation: Pyatak EA, Carandang K, Vigen CLP, Blanchard J, Diaz J, Concha-Chavez A, Sequeira PA, Wood JR, Whittemore R, Spruijt-Metz D, Peters AL. Occupational Therapy Intervention Improves Glycemic Control and Quality of Life Among Young Adults With Diabetes: the Resilient, Empowered, Active Living with Diabetes (REAL Diabetes) Randomized Controlled Trial. Diabetes Care. 2018 Apr;41(4):696-704. doi: 10.2337/dc17-1634. Epub 2018 Jan 19.
PMID: 29351961
responsible party type: Sponsor
mesh term: Diabetes Mellitus
mesh term: Diabetes Mellitus, Type 2
sharing ipd: No