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Comparison Study of Usual Care vs. Usual Care Plus Community Intervention to Manage Type 2 Diabetes

28. august 2019 oppdatert av: 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.

Studieoversikt

Detaljert 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

  1. To determine if a 6-month, IP, community-based intervention improve self-management compared with usual primary care services?
  2. 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?
  3. To determine the effectiveness of the intervention on HRQoL of family caregivers compared with usual primary care?
  4. To assess whether or not the intervention improves clinical practice behaviours?
  5. To determine the 6-month costs of use of health services of the intervention compared with usual care, from a social perspective?
  6. To identify which subgroups of older adults with T2DM and MCC benefit most from the intervention?
  7. To determine the effectiveness of the intervention based on sex/gender and region?
  8. 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?

Studietype

Intervensjonell

Registrering (Faktiske)

291

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Alberta
      • Edmonton, Alberta, Canada
        • Edmonton Oliver PCN
      • Leduc, Alberta, Canada, T9E 6W2
        • Leduc Beaumont Devon PCN
      • Sherwood Park, Alberta, Canada
        • Sherwood Park PCN
    • Ontario
      • Hamilton, Ontario, Canada, L8S 4K1
        • McMaster University
      • Lindsay, Ontario, Canada
        • Ross Memorial Hospital
      • London, Ontario, Canada
        • St. Joseph's Health Care
      • Peterborough, Ontario, Canada
        • Peterborough Regional Health Centre
      • Port Hope, Ontario, Canada
        • Port Hope Community Health Centre

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

65 år og eldre (Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Helsetjenesteforskning
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Ingen inngripen: Usual Primary Care
Usual Primary Care will be received by half the participants during the course of the Study
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Summary of Diabetes Self-Care Activities
Tidsramme: Every two months from study onset until the end of study (6 months from baseline)
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.
Every two months from study onset until the end of study (6 months from baseline)

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
SF12v2
Tidsramme: Baseline and end of study (6 months from baseline)
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
Baseline and end of study (6 months from baseline)

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
CES-D-10
Tidsramme: Baseline and end of study (6 months from baseline)
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.
Baseline and end of study (6 months from baseline)
GAD-7
Tidsramme: Baseline and end of study (6 months from baseline)
Prevalence and severity of anxiety, measured by the Generalized Anxiety Disorder Screener
Baseline and end of study (6 months from baseline)
Health Assessment forms
Tidsramme: Baseline intervention interview, at 3 months and again at 6 months
• 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.
Baseline intervention interview, at 3 months and again at 6 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Hovedetterforsker: Maureen Markle-Reid, PhD, McMaster University
  • Hovedetterforsker: Jenny Ploeg, PhD, McMaster University

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. september 2014

Primær fullføring (Faktiske)

1. mai 2017

Studiet fullført (Faktiske)

1. mai 2017

Datoer for studieregistrering

Først innsendt

3. juni 2014

Først innsendt som oppfylte QC-kriteriene

6. juni 2014

Først lagt ut (Anslag)

9. juni 2014

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

30. august 2019

Siste oppdatering sendt inn som oppfylte QC-kriteriene

28. august 2019

Sist bekreftet

1. august 2019

Mer informasjon

Begreper knyttet til denne studien

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

Kliniske studier på Type 2 diabetes mellitus

Kliniske studier på Home Visits and Lifestyle Education Support

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