NCT05728411

Brief Summary

Diabetic foot ulcers are common, debilitating, and costly complications of diabetes, disproportionately impacting Black and rural Veterans. Forty percent of individuals have an ulcer recurrence within a year of ulcer healing and 65% within 5 years. Monitoring plantar foot temperatures is one of the few interventions that reduces the risk of ulcer recurrence. Despite the evidence, adoption has been poor because the original procedures, including the use of handheld thermometers, were burdensome and time-consuming. Podimetrics, a private company, has developed a temperature monitoring system involving a "smart" mat that can wirelessly transmit data and a remote monitoring team that works with VA providers to assist with triage and monitoring. This care model has incredible promise, but has been untested in VA. The investigators propose to conduct a randomized trial to evaluate effectiveness of remote temperature monitoring as well as costs. Additionally, the investigators will evaluate the implementation process, including barriers and facilitators to use among key stakeholders.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
800

participants targeted

Target at P75+ for not_applicable

Timeline
68mo left

Started Oct 2023

Longer than P75 for not_applicable

Geographic Reach
1 country

4 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress32%
Oct 2023Dec 2031

First Submitted

Initial submission to the registry

February 3, 2023

Completed
12 days until next milestone

First Posted

Study publicly available on registry

February 15, 2023

Completed
8 months until next milestone

Study Start

First participant enrolled

October 2, 2023

Completed
3.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2026

Expected
5 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2031

Last Updated

September 11, 2025

Status Verified

September 1, 2025

Enrollment Period

3.2 years

First QC Date

February 3, 2023

Last Update Submit

September 4, 2025

Conditions

Keywords

diabetic footDept. of Veterans Affairsremote sensing technology

Outcome Measures

Primary Outcomes (1)

  • Rate of foot ulceration

    The primary outcome is the presence of new ulceration through 24 months

    24 months

Secondary Outcomes (4)

  • Rate of lower limb amputation

    24 months

  • Mean or median quality of life scores

    6,12, 18 and 24 months

  • Mean or median satisfaction with care scores

    6,12, 18 and 24 months

  • Mean or median self-efficacy for diabetes

    6, 12, 18, and 24 months

Other Outcomes (1)

  • Utilization (outpatient visits, emergency room visits, hospitalizations) - any vs. none and number

    6, 12, 18, and 24 months

Study Arms (2)

Remote temperature monitoring + enhanced usual care

EXPERIMENTAL

Enrollment in remote foot temperature monitoring in addition to enhanced usual care (described below)

Other: Remote foot temperature monitoring systemOther: Enhanced usual care

Enhanced usual care

OTHER

Usual care is based on the VA's amputation prevention program (PAVE - Preventing Amputation in Veterans Everywhere - VHA Directive 1410), which provides a model of care for patients at risk for amputation as well as patients who have already undergone an amputation. Usual care will be enhanced by providing resources (e.g., information through written newsletters) relevant to a population of Veterans with diabetes, including information on nutrition and cooking, physical activities, and Whole Health opportunities

Other: Enhanced usual care

Interventions

Remote temperature monitoring involves a thermometric mat that can detect "hot spots" on the plantar surface of the foot. The mat has embedded cellular connectivity so that data can be transmitted from the patient's home to the company, where the temperature data can be analyzed. The company has a team of health coaches that work with patients and providers to detect signs of damage early in order to prevent ulceration.

Remote temperature monitoring + enhanced usual care

Usual care is based on the VA's amputation prevention program (PAVE - Preventing Amputation in Veterans Everywhere - VHA Directive 1410), which provides a model of care for patients at risk for amputation as well as patients who have already undergone an amputation. Usual care will be enhanced by providing resources (e.g., information through written newsletters) relevant to a population of Veterans with diabetes, including information on nutrition and cooking, physical activities, and whole health opportunities

Enhanced usual careRemote temperature monitoring + enhanced usual care

Eligibility Criteria

Age18 Years - 89 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Veteran
  • Diabetes diagnosis
  • History of foot ulcer (including active ulcer) OR history of lower extremity amputation (including unhealed amputation)
  • Able to understand/read English

You may not qualify if:

  • Dementia
  • Unable to ambulate
  • Bilateral lower extremity amputation
  • Ankle brachial index \<0.6 or toe brachial index \<0.5
  • Currently using in-home temperature monitoring
  • Prisoner

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

Edward Hines Jr. VA Hospital, Hines, IL

Hines, Illinois, 60141-3030, United States

RECRUITING

Richmond VA Medical Center, Richmond, VA

Richmond, Virginia, 23249-0001, United States

RECRUITING

VA Puget Sound Health Care System Seattle Division, Seattle, WA

Seattle, Washington, 98108-1532, United States

RECRUITING

Spokane VA Medical Center, Spokane, WA

Spokane, Washington, 99205-6185, United States

RECRUITING

MeSH Terms

Conditions

Diabetic Foot

Condition Hierarchy (Ancestors)

Diabetic AngiopathiesVascular DiseasesCardiovascular DiseasesFoot UlcerLeg UlcerSkin UlcerSkin DiseasesSkin and Connective Tissue DiseasesDiabetes ComplicationsDiabetes MellitusEndocrine System DiseasesDiabetic Neuropathies

Study Officials

  • Alyson J. Littman, PhD MPH

    VA Puget Sound Health Care System Seattle Division, Seattle, WA

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 3, 2023

First Posted

February 15, 2023

Study Start

October 2, 2023

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

December 31, 2031

Last Updated

September 11, 2025

Record last verified: 2025-09

Data Sharing

IPD Sharing
Will not share

Subject to IRB approval, de-identified data will be released to a local VAPSHCS and/or national VA research data repository for release to non-VA protocols. The VA research data repository administrator will be responsible for reviewing and responding to requests to release data to non-VA requesters. A data use agreement compliant with VHA Handbooks 1200.12 and 1605.1 will be required between VHA and the requester. Review and approval by VA privacy officer is required prior to disclosure.

Locations