Despite system-wide advances in diabetes quality of care, over 30% of patients with diabetes treated in Veterans Health Administration health centers continue to have poorly controlled blood pressure, hyperglycemia, or hyperlipidemia. The nationwide VA PACT (Patient-Aligned Care Team) initiative seeks to provide these patients with comprehensive, team-based support for following diabetes care regimens. One relatively untapped resource for supporting engagement in PACT is patients’ family and friends. Three out of four adults with diabetes reach out to an unpaid family member or friend (a ‘CarePartner’) for ongoing help with diabetes management. These CarePartners help patients with medication adherence, tracking home glucose measurements, maintaining a healthy eating plan, and often accompany patients to their medical visits. CarePartners report that, in order to be more effective, they need more information on patient’s medical care plans, clear channels for communicating with PACT team members, and information on navigating PACT resources.

In this randomized trial led by Ann-Marie Rosland, MD, MS, investigators are evaluating an intervention designed to activate dyads of CarePartners and veterans with diabetes. Two hundred forty patients receiving PACT primary care who are at high risk for diabetes complications will be recruited along with their CarePartner. Patient-supporter dyads will be randomized to the Caring Others Increasing EngageMent in PACT (CO-IMPACT) intervention or usual PACT care for 12 months. The CO-IMPACT intervention provides dyads with coaching for action planning, communicating with providers, navigation and support skills training, preparation by phone before patients’ primary care visits, after-visit summaries, and biweekly automated phone calls to prompt dyad action on new patient health concerns. The project builds on CMCD’s expertise in supporting diabetes patients and their family caregivers through mobile health tools.

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