Trial · NCT02587936

Improving Chronic Disease Management With Pieces

NCT02587936, Not applicable, Completed, University of Texas Southwestern Medical Center; results first posted 2023-12-20

3 sourcestrials-2026-11-12-0.5.0

Download JSON

Cite this record

ConductScience Library. Improving Chronic Disease Management With Pieces. Trials, record NCT02587936. Release trials-2026-11-12-0.5.0, 12 Nov 2026. https://conductscience.org/library/trials/NCT02587936

On this page

Trial

As registered on ClinicalTrials.gov, in the graph's capture of the registry.

Title: Improving Chronic Disease Management With Pieces
NCT number: NCT02587936
Status: Completed
Phases: Not applicable
Enrollment: 18,268 participants, actual
Lead sponsor: University of Texas Southwestern Medical Center
Conditions: Chronic Kidney Disease, Diabetes, Hypertension, High BP, Type 2 Diabetes
Interventions: Collaborative Model of Primary care and Subspecialty care
First posted: 2015-10-27
Last updated: 2024-04-02
Results first posted: 2023-12-20

Source ClinicalTrials.gov

Registered outcomes2

Each outcome the trial registered, primary first, in ClinicalTrials.gov's words.

List	Outcome	Time frame	Description
Primary	All Cause Hospitalizations for Patients With a Triad of Chronic Kidney Disease, Diabetes and Hypertension	12 months	Hospitalization rates at 12 months for all study participants, capturing all cause unplanned hospitalizations including both regular hospitalizations as currently defined by CMS and observation status overnight. Hospitalizations will be ascertained from Electronic Health Record of each participating healthcare system with assistance from Pieces.
Secondary	30-day All Cause Readmissions (for Those Patients Who Have an Index Hospitalization)	12 months	30-day all-cause readmissions (for those patients who have an index hospitalization), emergency room visits, cardiovascular events and deaths, and disease-specific hospitalizations for cardiovascular complications, congestive heart failure, volume overload, hypertension complications, acute coronary syndrome, myocardial infarction, coronary/peripheral revascularization, stroke, amputation/limb ischemia, uncontrolled diabetes, hypoglycemia, diabetes complications, acute kidney injury, hyperkalemia, electrolyte disturbances, medication errors, drug toxicity, and infections.

Source ClinicalTrials.gov

Outcomes2

Each outcome the trial posted results for, in ClinicalTrials.gov's words.

Type	Outcome	Time frame	Population	Units	Measured as
PRIMARY	All Cause Hospitalizations for Patients With a Triad of Chronic Kidney Disease, Diabetes and Hypertension	12 months		percentage of participants hospitalized	NUMBER
SECONDARY	30-day All Cause Readmissions (for Those Patients Who Have an Index Hospitalization)	12 months		participants	NUMBER

Source ClinicalTrials.gov

Results by group4

Each measurement the trial posted, group by group, in the words and numbers it posted.

Outcome	Group	Value	Spread	Units
All Cause Hospitalizations for Patients With a Triad of Chronic Kidney Disease, Diabetes and Hypertension	Intervention	20.7	95% Confidence Interval 19.6509 to 21.7912	percentage of participants hospitalized
All Cause Hospitalizations for Patients With a Triad of Chronic Kidney Disease, Diabetes and Hypertension	Usual Care	21.12	95% Confidence Interval 20.0657 to 22.2251	percentage of participants hospitalized
30-day All Cause Readmissions (for Those Patients Who Have an Index Hospitalization)	Intervention	429		participants
30-day All Cause Readmissions (for Those Patients Who Have an Index Hospitalization)	Usual Care	433		participants

Source ClinicalTrials.gov

Participant flow6

How many started, completed or left each group, period by period.

Period	Milestone	Group	Participants	Units counted
Overall Study	STARTED	Intervention	9,730	71
Overall Study	STARTED	Usual Care	8,538	70
Overall Study	COMPLETED	Intervention	5,508	71
Overall Study	COMPLETED	Usual Care	5,492	70
Overall Study	NOT COMPLETED	Intervention	4,222	0
Overall Study	NOT COMPLETED	Usual Care	3,046	0

Source ClinicalTrials.gov

Adverse events32

Each adverse event the trial posted, group by group: the participants affected out of those at risk.

Type	Event	Organ system	Group	Affected	At risk
other	Acute Kidney Injury	Renal and urinary disorders	Intervention	701	5,508
other	Acute Kidney Injury	Renal and urinary disorders	Usual Care	619	5,492
other	Cellulitis	Skin and subcutaneous tissue disorders	Intervention	215	5,508
other	Cellulitis	Skin and subcutaneous tissue disorders	Usual Care	185	5,492
other	Drug toxicity	Product Issues	Intervention	7	5,508
other	Drug toxicity	Product Issues	Usual Care	6	5,492
other	Fluid overload	Renal and urinary disorders	Intervention	50	5,508
other	Fluid overload	Renal and urinary disorders	Usual Care	37	5,492
other	Hyperkalemia	Blood and lymphatic system disorders	Intervention	160	5,508
other	Hyperkalemia	Blood and lymphatic system disorders	Usual Care	149	5,492

1 to 10 of 32Source ClinicalTrials.gov

See all 32 adverse events

Adverse event totals6

The totals the trial posted for each group.

Total	Group	Affected	At risk
Total, all-cause mortality	Intervention	129	5,508
Total, all-cause mortality	Usual Care	148	5,492
Total, other adverse events	Intervention	1,426	5,508
Total, other adverse events	Usual Care	1,475	5,492
Total, serious adverse events	Intervention	1,193	5,508
Total, serious adverse events	Usual Care	1,223	5,492

Source ClinicalTrials.gov

Papers1

The papers the trial lists on ClinicalTrials.gov.

PMID	Listed as
38598574	DERIVED

Source PubMed

Grants2

The grants NIH RePORTER links to the trial, newest funded first: NIH's, and some of AHRQ's, CDC's, FDA's and VA's. Each shows its title, principal investigators, organization and funder in its newest year.

Project	Title	Principal investigators	Organization	Funder	Fiscal years	Source
UH3DK104655	Improving Chronic Disease Management with Pieces (ICD-Pieces)	VAZQUEZ, MIGUEL A	UT SOUTHWESTERN MEDICAL CENTER	NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES	2015 to 2019	NIH RePORTER
UH2DK104655	Improving Chronic Disease Management with Pieces (ICD-Pieces)	VAZQUEZ, MIGUEL A	UT SOUTHWESTERN MEDICAL CENTER	NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES	2014	NIH RePORTER

Trial comparisons3

Comparisons of the trial's two groups, calculated by ConductScience from the counts it posted.

Comparison	Source
Intervention vs Usual Care: 30-day All Cause Readmissions (for Those Patients Who Have an Index Hospitalization)	Trial comparisons
Intervention vs Usual Care: deaths from any cause	Trial comparisons
Intervention vs Usual Care: serious adverse events	Trial comparisons

Tests0

The ConductCognition tests this trial's registered outcomes name, as ScienceGraph matched them in trial-tests-2026-11-12-0.2.1.

None in this release.

Data dates

The day each source was copied for this release.

ClinicalTrials.gov: 2026-11-12; ClinicalTrials.gov
Results, from AACT: 2026-03-23; AACT
NIH grant links: 2026-11-13; NIH RePORTER

Sources 3

ClinicalTrials.gov's posted results, through CTTI's AACTFreely available. Acknowledgement requested
ClinicalTrials.govNo license stated
NIH RePORTER's clinical studies and project filesPublic domain

Each source's terms

ClinicalTrials.gov's posted results, through CTTI's AACTClinicalTrials.gov data via Aggregate Analysis of ClinicalTrials.gov (AACT), CTTI. CTTI makes its materials freely available and requests acknowledgement. https://aact.ctti-clinicaltrials.org/documentation/299
ClinicalTrials.govnone stated
NIH RePORTER's clinical studies and project filesPublic domain (NIH RePORTER)

ClinicalTrials.gov's data carry an international copyright outside the United States: https://clinicaltrials.gov/about-site/terms-conditions.

For software

Read this trial from software.

The record and each of its lists are JSON, twenty rows a page. No key.

GET https://conductscience.org/api/trials/v1/NCT02587936

GET https://conductscience.org/api/trials/v1/NCT02587936/events?page=2

API reference For AI assistants