Shared Care for Patients With Type 2 Diabetes Across the Primary and Secondary Health Care Sector

Diabetes Mellitus, Type 2 Clinical Trial

Official title:

Shared Care for Patients With Type 2 Diabetes Across the Primary and Secondary Health Care Sector

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02586545
• Other study ID #: DIA-1234
• Status: Completed
• Phase: N/A
• Start date: August 2015
• Est. completion date: December 2018

Study information

• Verified date: January 2019
• Source: University Hospital, Gentofte, Copenhagen
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of the study is to test the effect of a new shared care model for type 2 diabetes care and compare it with a standardized care management program in a specialized hospital-based out-patient clinic.

The hypothesis is that participants with type 2 diabetes followed in a shared care program will have a comparable outcome in HbA1c to participants receiving standard care.

Description:

The prevalence of patients with type 2 diabetes is in growth globally. In order to secure high quality in diabetes care it is necessary to rethink the way in which the care is organized. The investigators want to test a new model of shared care across the interface of primary and secondary care sector for patients with type 2 diabetes who are at risk stratification level 2. Based on a national and regional risk stratification model patients can be stratified to three levels according to risk and complexity of treatment: level 1 (uncomplicated), level 2 (intermediate risk) and level 3 (high risk).

The objective of the study is to show equal outcomes among the participants being treated in either a shared care program or an established program in a specialized outpatient clinic.

The study is a non-inferiority randomized controlled trial. The shared care model will be tested during a period of three years. All participants are offered four medical visits a year. The shared care intervention consists of one annual comprehensive check-up at the outpatient clinic and three quarterly visits at a general practice. The control group is followed with four quarterly visits at the outpatient clinic including an annual comprehensive check-up. The recruitment period spans over approximately 12 months, and participants are randomized to intervention or control group in a 1:1 ratio.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 140
• Est. completion date: December 2018
• Est. primary completion date: December 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Must be over the age of 18 years

• The diagnosis of type 2 diabetes

• Risk stratification level 2

• Capable of speaking and writing in Danish

• Give oral and written consent before entering the study

Exclusion Criteria:

• Diagnosed with other types of diabetes than type 2 diabetes

• Risk stratification level 1 or 3

• Being pregnant or breastfeeding

• Having severe co-morbidity with life expectancy less than five years

• Being under such conditions, that the patient will not be able to show up or go through with the appointments (e.g. moderate to severe dementia and severe psychiatric conditions)

• Participating in long-lasting interventions (>2 weeks) that potentially affects the primary outcome in our study or patients participating in studies which include blood sampling amounting to >5 % of the blood volume two months prior to the randomisation and/or the follow-up visits

Related Conditions & MeSH terms

• Diabetes Mellitus
• Diabetes Mellitus, Type 2

Intervention

Other:
• Shared care

Locations

Country	Name	City	State
Denmark	Center for Diabetes Research, Gentofte Hospital, University of Copenhagen	Hellerup

Sponsors (2)

Lead Sponsor	Collaborator
University Hospital, Gentofte, Copenhagen	Metropolitan University College

Country where clinical trial is conducted

Denmark, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Change from baseline Quality of life at 12, 24 and 36 months	Measured by the Short Form 36 (SF-36)	Baseline and follow-up at 12, 24 and 36 months
Other	Change from baseline blood pressure at 12, 24 and 36 months		Baseline and follow-up at 12, 24 and 36 months
Other	Change from baseline diabetes symptoms at 12, 24 and 36 months	Meassured by the Diabetes Symptom Checklist-revised (DSC-r).	Baseline and follow-up at 12, 24 and 36 months
Primary	Change from baseline Hemoglobin A, Glycosylated (HbA1c) at 12, 24 and 36 months		Baseline and follow-up at 12, 24 and 36 months
Secondary	The proportion of patients who meet national standard indicators reflecting quality of care	These indicators cover seven areas: HbA1c, blood pressure, low density lipoprotein, albuminuria, fundoscopy, foot examination and smoking status.	Follow-up at 12, 24 and 36 months after baseline