- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT02158741
Comparison Study of Usual Care vs. Usual Care Plus Community Intervention to Manage Type 2 Diabetes
28. august 2019 opdateret af: Maureen Markle-Reid, McMaster University
A Client-Driven Intervention to Support Self-Management Among Community-Living Older Adults With Type 2 Diabetes and Multiple Chronic Conditions
The overall purpose of this research is to examine and compare the effectiveness and costs of a community-based intervention to support self-management with usual primary care for older adults with Type 2 Diabetes Mellitus and multiple chronic conditions and their family caregivers.
Once the study is complete, the investigators will be able to determine if there is any measurable difference in self-care management between usual care plus the intervention versus usual care alone.
Studieoversigt
Status
Afsluttet
Intervention / Behandling
Detaljeret beskrivelse
Research Goal
To examine the comparative effectiveness and costs of a community-based intervention to support self-management with usual primary care for older adults with T2DM and Multiple Chronic Conditions and their family caregivers.
Objectives
- To determine if a 6-month, IP, community-based intervention improve self-management compared with usual primary care services?
- To compare the effectiveness of the intervention on HRQoL, physical activity, nutritional status, depression, anxiety, diabetes parameters (blood glucose levels [HbA1c, hypoglycemic episodes]), diabetes-related complications, number of vascular events, social support number of falls, fall risk and medication safety with usual primary care services?
- To determine the effectiveness of the intervention on HRQoL of family caregivers compared with usual primary care?
- To assess whether or not the intervention improves clinical practice behaviours?
- To determine the 6-month costs of use of health services of the intervention compared with usual care, from a social perspective?
- To identify which subgroups of older adults with T2DM and MCC benefit most from the intervention?
- To determine the effectiveness of the intervention based on sex/gender and region?
- To determine the overall feasibility and acceptability of an IP community-based health promotion intervention and what can be identified as barriers and facilitators to implementation?
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
291
Fase
- Ikke anvendelig
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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Alberta
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Edmonton, Alberta, Canada
- Edmonton Oliver PCN
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Leduc, Alberta, Canada, T9E 6W2
- Leduc Beaumont Devon PCN
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Sherwood Park, Alberta, Canada
- Sherwood Park PCN
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Ontario
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Hamilton, Ontario, Canada, L8S 4K1
- McMaster University
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Lindsay, Ontario, Canada
- Ross Memorial Hospital
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London, Ontario, Canada
- St. Joseph's Health Care
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Peterborough, Ontario, Canada
- Peterborough Regional Health Centre
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Port Hope, Ontario, Canada
- Port Hope Community Health Centre
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
65 år og ældre (Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion Criteria:
- older adults aged 65+
- live in the local vicinity of a participating Diabetes Education Program
- were referred to their Diabetes Education Program within the past 24 months
- competence in English (or access to a translator)
- intention to continue living in the area for the next 6 months
- two reported chronic conditions in addition to T2DM. Individuals with newly diagnosed T2DM as well as those who were already receiving treatment for T2DM will be eligible for inclusion in the study.
Exclusion Criteria:
- score of 20 or less in Montreal Cognitive Assessment (MoCA) test AND without access to a substitute decision maker to sign consent (Score of 20 or less is not in itself an exclusion).
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Sundhedstjenesteforskning
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
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Ingen indgriben: Usual Primary Care
Usual Primary Care will be received by half the participants during the course of the Study
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Aktiv komparator: Home Visits and educational support
Intervention comprised of Home Visits and group educational sessions.
Home Visits and will be conducted by Diabetes Education staff in lieu of usual care conducted at the Diabetes clinic.
Lifestyle support and educational will be offered in the form of monthly Diabetes Wellness Days offered in the community where nutrition, exercise and support will be given to help improve self-management of diabetes.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Summary of Diabetes Self-Care Activities
Tidsramme: Every two months from study onset until the end of study (6 months from baseline)
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The SDSCA is a multidimensional measure of diabetes self-management with adequate internal and test-retest reliability, and evidence of validity and sensitivity to change.
The revised SDSCA consists of items that assess the following aspects of the diabetes regimen: general and specific diet, exercise, blood-glucose testing, foot care, and smoking.
Scores are calculated for each of these five regimen areas.
This data is collected by the interventionists at each visit.
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Every two months from study onset until the end of study (6 months from baseline)
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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SF12v2
Tidsramme: Baseline and end of study (6 months from baseline)
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This measurement is used to assess Health related quality of Life.
This survey consists of 12 questions that measure functional health and well-being from the client's perspective.
It provides scores for eight health domains (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health), and psychometrically-based physical component summary (PCS) and mental component summary (MCS) scores
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Baseline and end of study (6 months from baseline)
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Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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CES-D-10
Tidsramme: Baseline and end of study (6 months from baseline)
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The CES-D has been used in prior studies of older adults with mood disorders, and has a high degree of reliability, content, construct and criterion related validity, distinguishes between depressed and non-depressed people, and is a sensitive tool for measuring changes in depressive symptoms over time in psychiatric populations.
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Baseline and end of study (6 months from baseline)
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GAD-7
Tidsramme: Baseline and end of study (6 months from baseline)
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Prevalence and severity of anxiety, measured by the Generalized Anxiety Disorder Screener
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Baseline and end of study (6 months from baseline)
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Health Assessment forms
Tidsramme: Baseline intervention interview, at 3 months and again at 6 months
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• Diabetes parameters (fasting blood glucose, HbA1c, hypoglycemic episodes), and presence of diabetes-related complications and comorbid chronic conditions, obtained from health assessment forms submitted by the Diabetes Education Program RN and RD after the first home visit and at 3 months and 6 months.
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Baseline intervention interview, at 3 months and again at 6 months
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Maureen Markle-Reid, PhD, McMaster University
- Ledende efterforsker: Jenny Ploeg, PhD, McMaster University
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Markle-Reid M, Ploeg J, Valaitis R, Duggleby W, Fisher K, Fraser K, Ganann R, Griffith LE, Gruneir A, McAiney C, Williams A. Protocol for a program of research from the Aging, Community and Health Research Unit: Promoting optimal aging at home for older adults with multimorbidity. J Comorb. 2018 Jul 31;8(1):2235042X18789508. doi: 10.1177/2235042X18789508. eCollection 2018.
- Markle-Reid M, Ploeg J, Fraser KD, Fisher KA, Bartholomew A, Griffith LE, Miklavcic J, Gafni A, Thabane L, Upshur R. Community Program Improves Quality of Life and Self-Management in Older Adults with Diabetes Mellitus and Comorbidity. J Am Geriatr Soc. 2018 Feb;66(2):263-273. doi: 10.1111/jgs.15173. Epub 2017 Nov 27.
- Miklavcic JJ, Fraser KD, Ploeg J, Markle-Reid M, Fisher K, Gafni A, Griffith LE, Hirst S, Sadowski CA, Thabane L, Triscott JAC, Upshur R. Effectiveness of a community program for older adults with type 2 diabetes and multimorbidity: a pragmatic randomized controlled trial. BMC Geriatr. 2020 May 13;20(1):174. doi: 10.1186/s12877-020-01557-0.
- Markle-Reid M, Ploeg J, Fraser KD, Fisher KA, Akhtar-Danesh N, Bartholomew A, Gafni A, Gruneir A, Hirst SP, Kaasalainen S, Stradiotto CK, Miklavcic J, Rojas-Fernandez C, Sadowski CA, Thabane L, Triscott JA, Upshur R. The ACHRU-CPP versus usual care for older adults with type-2 diabetes and multiple chronic conditions and their family caregivers: study protocol for a randomized controlled trial. Trials. 2017 Feb 6;18(1):55. doi: 10.1186/s13063-017-1795-9.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. september 2014
Primær færdiggørelse (Faktiske)
1. maj 2017
Studieafslutning (Faktiske)
1. maj 2017
Datoer for studieregistrering
Først indsendt
3. juni 2014
Først indsendt, der opfyldte QC-kriterier
6. juni 2014
Først opslået (Skøn)
9. juni 2014
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
30. august 2019
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
28. august 2019
Sidst verificeret
1. august 2019
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- DRCT-06669
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Type 2 diabetes mellitus
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Instituto Nacional de Ciencias Medicas y Nutricion...Aktiv, ikke rekrutterende
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Endogenex, Inc.Ikke rekrutterer endnuDiabetes mellitus, type 2 | Diabetes | Type 2 diabetes | Type 2 diabetes mellitus (T2DM) | Type 2 Diabetes
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ENBIOSIS BIOTECHNOLOGIESAydin Adnan Menderes University; Izmir University of Economics; Buca Seyfi... og andre samarbejdspartnereIkke rekrutterer endnuType 2 diabetes | Diabetes mellitus type 2Tyrkiet (Türkiye)
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Endogenex, Inc.Ikke rekrutterer endnuDiabetes mellitus, type 2 | Diabetes | Type 2 diabetes mellitus | Type 2 diabetes | Type 2 diabetes
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University Hospital Inselspital, BerneAfsluttetType 2 diabetes mellitusSchweiz
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India Diabetes Research Foundation & Dr. A. Ramachandran...Afsluttet
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El Katib HospitalIkke rekrutterer endnuType 2 diabetes mellitus (T2DM)
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He Eye HospitalIkke rekrutterer endnu
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Diabetes Solutions InternationalDexCom, Inc.; Tidepool; MAVEN ProjectRekrutteringType 2 diabetes mellitus (T2DM)Forenede Stater
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Global Institute of Stem Cell Therapy and ResearchIkke rekrutterer endnu
Kliniske forsøg med Home Visits and Lifestyle Education Support
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University of MichiganNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Afsluttet
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March of Dimes, CanadaHamilton Health Sciences CorporationAfsluttet
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Omada Health, Inc.Palo Alto Medical Foundation; Sutter HealthAfsluttetType 2 diabetesForenede Stater
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Peking UniversityAktiv, ikke rekrutterendeDepression læsefærdighed | Depressionslidelser | Stigma af psykisk sygdomKina
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University of ArizonaAfsluttet
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University of ArkansasTrukket tilbageDiabetes mellitus, type 2 | SøvnhygiejneForenede Stater
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Omada Health, Inc.Abbott Diabetes Care; Evidation HealthAfsluttetType 2 diabetesForenede Stater
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University of PittsburghNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Aktiv, ikke rekrutterendeType 1-diabetes (T1D)Forenede Stater
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Psychiatric Research Unit, Region Zealand, DenmarkTrukket tilbagePsykiatrisk indlæggelse
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University of MichiganNational Institute on Aging (NIA)AfsluttetKronisk smerte | Kognitiv svækkelseForenede Stater