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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT04819256
Other study ID # 2020/2202
Secondary ID
Status Terminated
Phase N/A
First received
Last updated
Start date December 7, 2020
Est. completion date February 8, 2022

Study information

Verified date April 2022
Source SingHealth Polyclinics
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

PACE-It study is a non-blinded, mix-method randomized controlled trial within a single site. This study aims to test the feasibility of implementing a complex intervention comprising of a) a Primary Care Based integrated community care team delivery of person centered care, b) supported by a care co-ordination platform using a mobile application and its effectiveness in improving the glycemic control of patients living with Diabetes and have complex needs.


Description:

PACE-It study aims to test the feasibility of implementing a complex intervention comprising of a) a Primary Care Based Community Care Team delivery of person centered care b) supported by a care co-ordination platform using a mobile application and its effectiveness in improving the glycemic control of patients living with Diabetes and complex needs. This is a non-blinded, mix-method randomised controlled trial within the Marine Parade Community. The primary outcome will be glycemic control measure by the Glycated Haemoglobin (HbA1c). Secondary outcomes include blood pressure, LDL-cholesterol, Patient Activation Measure, Medication Adherence and Quality of Life. Data on patient and provider satisfaction and implementation process will be collected by the Qualitative method.


Recruitment information / eligibility

Status Terminated
Enrollment 41
Est. completion date February 8, 2022
Est. primary completion date February 8, 2022
Accepts healthy volunteers No
Gender All
Age group 50 Years and older
Eligibility Inclusion Criteria: - Living within the designated geographical zone - 50 years and above - Satisfy the Medical Criteria below: 1. Diabetes with HbA1c = 9% (within past 6 months), and 2. At least 1 complication 1. chronic kidney impairment stage 3 and above, or diabetes overt nephropathy, 2. ischaemic heart disease, or congestive cardiac failure, 3. peripheral arterial disease, or diabetes foot/ diabetes foot-related complications, 4. diabetic retinopathy/ treatment for retinopathy, and 5. stroke, or transient ischaemic attack - Satisfy at least 2 conditions in the psycho-social, functional or activation domain of which 1 criteria must be from the psycho-social domain: 1. Psycho-social issues a. Lack of care giver support i. No care-giver (when indicated) ii. Care-giver skills gap/ stress iii. Inability of copy when patient is the care-giver b. Difficult relationships (family/ workplace/ social network) c. Social isolation/ lack of social connectivity i. Lives alone ii. Lack of social network support d. Financial i. Financial difficulty/ insecurity ii. Housing/ shelter issues iii. Poor money management 2. Functional 1. Clinical Frailty Score = 4, requiring help in instrumental activities of daily living (iADL) 2. Requires assistance in ADL or iADL 3. Activation a. Lack of ability to manage health - disengaged or overwhelmed i. Anxiety or disease-related distress ii. Confusion or lack of understanding of care plans iii. Non-adherence to medications/ follow up - Patient gives consent to participate - For patients who may be seeing a Primary Care Physician (PCP) outside of the polyclinic for chronic disease management and where the PCP has indicated consent to co-manage the patient with the PACE-It team including the polyclinic physician - Patient must be willing to receive care in the polyclinic Exclusion Criteria: - Patients who are on follow up with Primary Care Physicians or General Practitioners elsewhere for management of their chronic conditions and they do not consent to co-managing patient with the PACE-It team - Patients who have severe cognitive impairment, depression or psychiatric conditions that interfere with the ability to engage with the healthcare team - Patients who are (i) not community ambulant or (ii) bed bound - Patients with terminal illness - Patients who have are in other programs or research studies - Patients who do not give consent

Study Design


Intervention

Other:
PACE-It mobile application
Care co-ordination platform

Locations

Country Name City State
Singapore SingHealth Polyclinics - Marine Parade, 80 Marine Parade Central, #01-792 Singapore

Sponsors (4)

Lead Sponsor Collaborator
SingHealth Polyclinics Agency for Integrated Care, Singapore, Ministry of Health, Singapore, SingHealth Regional Health System

Country where clinical trial is conducted

Singapore, 

Outcome

Type Measure Description Time frame Safety issue
Primary HbA1c Glycemic control 1 year
Secondary Blood pressure Systolic and diastolic blood pressure (mmHg) 1 year
Secondary LDL-cholesterol Low-density lipoprotein cholesterol 1 year
Secondary Patient activation measure (PAM) Patient's activation levels 1 year
Secondary Medication adherence measure (MARS-5) Patient's adherence to medication 1 year
Secondary EQ-5D-5L Quality of life 1 year
Secondary Patient satisfaction Qualitative survey and interview 1 year
Secondary Provider's satisfaction Qualitative survey and interview 2 years
Secondary Cost-effectiveness Cost-effectiveness of care model 2 years
Secondary Implementation of care model Factors affecting implementation of care model 2 years
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