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- Ensaio Clínico NCT04616053
IMPACT Intervention
A Randomised Controlled Trial to Evaluate the Effectiveness of a Multidisciplinary Team Intervention on Glycaemic Control for Disadvantaged Type 2 Diabetes Patients in France.
Introduction :
The prevalence of type 2 diabetes is increasing in France, especially in deprived districts.
The Itineraires Medico-sociaux Programme d'Accompagnement sur un Territoire (IMPACT) intervention is intended for disadvantaged patients with a chronic disease (not only type 2 diabetes).
The IMPACT intervention offers coordinated and patient-centered care by a multidisciplinary team with an empowerment approach. This personalised intervention lasts 6 months.
This study aims to evaluate the effect of 6 months IMPACT intervention on glycaemic control (glycated haemoglobin - HbA1c) of patients with type 2 diabetes in deprived districts.
Method :
This will be a randomised, controlled, parallel group, multicenter, open-label trial. 140 adults with type 2 diabetes will be randomised in two arms : IMPACT intervention group (n : 70) and usual care group (n : 70). The primary outcome is change in glycated haemoglobin (HbA1c) from baseline to 6 months. The primary outcome will be analysed using a linear mixed effects model.
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
This will be a randomised, controlled, parallel group, multicenter, open-label trial. Patients will be recruited among patients with type 2 diabetes referred to the IMPACT intervention.
144 patients will be randomised in two arms : IMPACT intervention group (n : 72) and usual care group (n : 72).
IMPACT intervention : a referent is assigned to the patient. A referent is a health worker (nurse, nutritionist, psychologist …). Patient builds with his referent a free care program. The patient can choose individual consultation (for example : nutrition, tabacology, psychology …) and/or collective care (for example : patient education, physical activity, relaxation …). A community health worker can help patients with his health administrative procedures.
Patients will have 3 visits. First visit (inclusion visit) : investigator collects baseline characteristics (sociodemographic data, comorbidity, treatment, diabetes complications, weight, height, body mass index, impedancemetry, HbA1c, lipids, creatinine, albuminuria/creatinuria ratio). Then the patient will be randomised.
Second visit (midpoint visit) : investigator collects weight, BMI, impedancemetry, HbA1c and adverse events Third visit (end point visit) : investigator collects weight, BMI, impedancemetry, HbA1c, lipids and adverse events.
Analysis : The primary outcome is change in glycated haemoglobin (HbA1c) from baseline to 6 months. The primary outcome will be analysed using a linear mixed effects model. Study groups, districts, time, group-time interaction and district-group interaction will be included as fixed effects. The model will include patients as a random effect. Sub-group analysis will be made with baseline HbA1c, sex, age, Epices score (French precarity score) and diabetes duration. The robustness of the model will be tested by replacing missing data with multiple imputation methods. The same statistical modelling approach will be used for the secondary outcomes.
Tipo de estudo
Inscrição (Antecipado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Donatien Talon, Resident
- Número de telefone: +33679230064
- E-mail: donatien.talon@gmail.com
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- Patients with type 2 diabetes
- Inclusion HbA1c > 7.5%
- Live in Hauts de Chambéry, Biollay or Renaudie district
- Be able to give written consent
Exclusion Criteria:
- Severe cognitive or psychological disorder that may affect study understanding
- Pregnant or breastfeeding women
- Had IMPACT intervention in the previous 24 months
- Concurrent participation in another study
- Concurrent participation in another diabetes educational care program
- Life expectancy less than 6 months
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
---|---|
Sem intervenção: Grupo de controle
Cuidados usuais
|
|
Experimental: Intervention group
IMPACT intervention
|
A referent is assigned to the patient.
A referent is a health worker (nurse, nutritionist, psychologist …).
Patient builds with his referent a free care program (without condition or limit).
The patient can choose individual consultation (for example : nutrition, tabacology, psychology …) and/or collective care (for example : patient education, physical activity, relaxation …).
A community health worker can help patient with his health administrative procedures.
This intervention lasts 6 months.
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
HbA1c
Prazo: From baseline to 6 months
|
Change in glycated haemoglobin (HbA1c)
|
From baseline to 6 months
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
HbA1c
Prazo: From baseline to 3 months
|
Change in glycated haemoglobin (HbA1c)
|
From baseline to 3 months
|
Weight
Prazo: At Months 3 and 6 from baseline
|
Change in weight
|
At Months 3 and 6 from baseline
|
Body mass index
Prazo: At Months 3 and 6 from baseline
|
Change in body mass index
|
At Months 3 and 6 from baseline
|
Body fat mass (Bioelectrical impedance analysis)
Prazo: At Months 3 and 6 from baseline
|
Change in body fat mass
|
At Months 3 and 6 from baseline
|
Body fat percentage (Bioelectrical impedance analysis)
Prazo: At Months 3 and 6 from baseline
|
Change in body fat percentage
|
At Months 3 and 6 from baseline
|
Muscle mass (Bioelectrical impedance analysis)
Prazo: At Months 3 and 6 from baseline
|
Change in muscle mass.
|
At Months 3 and 6 from baseline
|
Lipids - HDL cholesterol
Prazo: From baseline to 6 months
|
Change in HDL cholesterol
|
From baseline to 6 months
|
Lipids - LDL cholesterol
Prazo: From baseline to 6 months
|
Change in LDL cholesterol
|
From baseline to 6 months
|
Lipids - triglycerides
Prazo: From baseline to 6 months
|
Change in triglycerides
|
From baseline to 6 months
|
Colaboradores e Investigadores
Patrocinador
Publicações e links úteis
Publicações Gerais
- Tricco AC, Ivers NM, Grimshaw JM, Moher D, Turner L, Galipeau J, Halperin I, Vachon B, Ramsay T, Manns B, Tonelli M, Shojania K. Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis. Lancet. 2012 Jun 16;379(9833):2252-61. doi: 10.1016/S0140-6736(12)60480-2. Epub 2012 Jun 9.
- Attridge M, Creamer J, Ramsden M, Cannings-John R, Hawthorne K. Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2014 Sep 4;(9):CD006424. doi: 10.1002/14651858.CD006424.pub3.
- Captieux M, Pearce G, Parke HL, Epiphaniou E, Wild S, Taylor SJC, Pinnock H. Supported self-management for people with type 2 diabetes: a meta-review of quantitative systematic reviews. BMJ Open. 2018 Dec 14;8(12):e024262. doi: 10.1136/bmjopen-2018-024262.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Antecipado)
Conclusão Primária (Antecipado)
Conclusão do estudo (Antecipado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- 2020-A02905-34
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