Effectiveness and Cost-effectiveness of the Diabetes Integrated Care Breakthrough Collaborative
- Conditions
- Diabetes Mellitus, Non-Insulin-Dependent
- Interventions
- Behavioral: Breakthrough collaborative
- Registration Number
- NCT00160017
- Lead Sponsor
- Radboud University Medical Center
- Brief Summary
The study tests whether implementing professional evidence-based guidelines and best practices for diabetes care -through participation of multidisciplinary teams in a Breakthrough collaborative- results in an improvement of diabetes care, its health outcomes and economic costs. Determinants of success are studied. Data on diabetes will also be used to better understand Breakthrough as an implementation or improvement method.
- Detailed Description
Diabetes mellitus as a chronic disease is a major and growing health care problem. Studies on the prevention of severe complications provide evidence for the necessity of tight control. Different interventions and models to achieve strict control and reduce diabetes related risks of complications are available. These are, however, not implemented in daily practice. Our study focuses on this implementation problem: it tests whether implementing professional evidence-based guidelines and best practices -through participation of multidisciplinary teams in the Breakthrough collaborative- results in an improvement of diabetes care, its health outcomes and economic costs.
Data on diabetes will also be used to explore and better understand the Breakthrough model as an implementation method. Only uncontrolled observational studies have, so far, described the outcomes of Breakthrough collaboratives. They also describe significant differences between teams in specific improvements made in patient care and organisational performance, resulting in different implementation and medical costs. There is hardly any information regarding these costs and the cost-effectiveness of collaboratives, and little knowledge about how they could be made more effective. Insight is also needed into the factors that influence the success of individual teams. There are no data regarding the sustainability of improvements.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1861
- each patient, male or female, visiting the hospital outpatient clinic or general practice with type II diabetes mellitus during a specified period. Patients should be able to read and write the Dutch language.
- pregnancy
- patients with a life expectancy < 1 year
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Collaborative group Breakthrough collaborative Participants (i.e. profesionals) participate in a Breakthrough Collaborative intervention to improve diabetes care so that patients are provided more often with diabetes care as described in guidelines
- Primary Outcome Measures
Name Time Method HbA1c baseline, after 12 months and after 24 months
- Secondary Outcome Measures
Name Time Method (I) to introduce self-management of patients, baseline, after 12 months and after 24 months (II) to change professional performance and the organisation of care (by implementing guidelines and local protocols focusing on the prevention of severe complications and introducing diabetes nurses) and baseline, after 12 months and after 24 months (III) to introduce a system to administrate clinical parameters. baseline, after 12 months and after 24 months These intermediate outcomes will be measured as well, in both the intervention and the control group. baseline, after 12 months and after 24 months To improve the patient outcomes mentioned above, teams are supported: baseline, after 12 months and after 24 months
Trial Locations
- Locations (52)
Mesos Medisch Centrum
🇳🇱Bilthoven, Utrecht, Netherlands
Huisartspraktijk28
🇳🇱Nijmegen, Gelderland, Netherlands
Huisartspraktijk7
🇳🇱Zuidhorn, Groningen, Netherlands
Huisartspraktijk De Poort10
🇳🇱Beuningen, Noord-Brabant, Netherlands
Huisartsenpraktijk Julianastraat14
🇳🇱Asten, Noord-Brabant, Netherlands
Praktijk Van Mechelen32
🇳🇱Dinteloord, Noord-Brabant, Netherlands
Quartz Transmuraal Centrum voor de Regio Helmond, Elkerliek ziekenhuis Provisorium 1e etage
🇳🇱Helmond, Noord-Brabant, Netherlands
Huisartspraktijk Vincenten12
🇳🇱Roosendaal, Noord-Brabant, Netherlands
Atrium Medisch Centrum, Polikliniek Interne Geneeskunde
🇳🇱Kerkrade, Limburg, Netherlands
Huisartspraktijk1
🇳🇱Alkmaar, Noord-Holland, Netherlands
Huisartspraktijk29
🇳🇱Amsterdam, Noord-Holland, Netherlands
Diaconessenhuis
🇳🇱Leiden, Zuid-Holland, Netherlands
Therapeuticum Lemminkäinen36
🇳🇱Groningen, Netherlands
Gezondheidscentrum Kanaleneiland38
🇳🇱Utrecht, Netherlands
Huisartspraktijk26
🇳🇱Schoorl, Noord-Holland, Netherlands
Gezondheidscentrum Stevenshof4
🇳🇱Leiden, Zuid-Holland, Netherlands
Academisch Ziekenhuis Groningen, Afdeling Inwendige Geneeskunde
🇳🇱Groningen, Netherlands
St. Annaziekenhuis, Maatschap Interne Geneeskunde
🇳🇱Geldrop, Noord-Brabant, Netherlands
Huisartsenpraktijk van den Nieuwenhof16
🇳🇱Helmond, Noord-Brabant, Netherlands
Huisartspraktijk31
🇳🇱Roosendaal, Noord-Brabant, Netherlands
Huisartspraktijk13
🇳🇱Roosendaal, Noord-Brabant, Netherlands
Huisartspraktijk30
🇳🇱Roosendaal, Noord-Brabant, Netherlands
Artsenpraktijk Ruiterstal11
🇳🇱Steenbergen, Noord-Brabant, Netherlands
Huisartspraktijk De Heelhoek9
🇳🇱Wijchen, Noord-Brabant, Netherlands
Medisch Centrum Alkmaar
🇳🇱Alkmaar, Noord-Holland, Netherlands
St. Lucas Andreas Ziekenhuis
🇳🇱Amsterdam, Noord-Holland, Netherlands
Slotervaartziekenhuis, Maatschap Interne
🇳🇱Amsterdam, Noord-Holland, Netherlands
Huisartspraktijk18
🇳🇱Amsterdam, Noord-Holland, Netherlands
Huisartspraktijk20
🇳🇱Amsterdam, Noord-Holland, Netherlands
Onze Lieve Vrouwe Gasthuis
🇳🇱Amsterdam, Noord-Holland, Netherlands
Huisartspraktijk21
🇳🇱Amsterdam, Noord-Holland, Netherlands
Huisartspraktijk23
🇳🇱Amsterdam, Noord-Holland, Netherlands
Huisartspraktijk25
🇳🇱Amsterdam, Noord-Holland, Netherlands
Huisartspraktijk5
🇳🇱Den Helder, Noord-Holland, Netherlands
Gemini Ziekenhuis
🇳🇱Den Helder, Noord-Holland, Netherlands
Huisartspraktijk2
🇳🇱Hoofddorp, Zuid-Holland, Netherlands
Huisartspraktijk3
🇳🇱Hoofddorp, Zuid-Holland, Netherlands
Medisch Centrum Het Joppe8
🇳🇱Leiden, Zuid-Holland, Netherlands
Huisartspraktijk35
🇳🇱Groningen, Netherlands
Huisartspraktijk Carnegiedreef37
🇳🇱Utrecht, Netherlands
Universitair Medisch Centrum St Radboud
🇳🇱Nijmegen, Gelderland, Netherlands
Huisartspraktijk33
🇳🇱Fijnaart, Noord-Brabant, Netherlands
Huisartsenpraktijk Scholten17
🇳🇱Helmond, Noord-Brabant, Netherlands
Huisartsenpraktijk Dams15
🇳🇱Helmond, Noord-Brabant, Netherlands
Huisartspraktijk34
🇳🇱Roosendaal, Noord-Brabant, Netherlands
Huisartspraktijk22
🇳🇱Someren, Noord-Brabant, Netherlands
Huisartspraktijk24
🇳🇱Amsterdam, Noord-Holland, Netherlands
Huisartspraktijk19
🇳🇱Amsterdam, Noord-Holland, Netherlands
Gezondheidscentrum "De Schooten"6
🇳🇱Den Helder, Noord-Holland, Netherlands
Spaarne Ziekenhuis, Afdeling Inwendige Geneeskunde
🇳🇱Haarlem, Noord-Holland, Netherlands
Huisartspraktijk27
🇳🇱Limmen, Noord-Holland, Netherlands
Leids Universitair Medisch Centrum
🇳🇱Leiden, Zuid-Holland, Netherlands