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Tertiary Prevention in Type II Diabetes Mellitus in Canary Islands Study

Not Applicable
Completed
Conditions
Type 2 Diabetes Mellitus
Interventions
Behavioral: Intervention to patients
Behavioral: Intervention to professionals
Other: Usual care
Registration Number
NCT01657227
Lead Sponsor
Servicio Canario de Salud
Brief Summary

Objective:

* To improve health outcomes of patients with type 2 diabetes mellitus (T2DM) by influencing disease self-management through lifestyle modification and by helping primary care professionals to improve health care provided to patients.

* To assess the effectiveness and cost-effectiveness of two complex interventions (education and behavioural modification, independently and conjointly, for primary health care teams (PHCT) and patients and their relatives) to improve the health results in people with T2DM.

Methodology:

Design: Randomized clinical trial. Setting: Basic healthcare district in Canary Islands. Spain. Subjects: Patients with T2DM, 18-65 years old, without complications. Main measures: HbA1c, rate of patients with properly controlled T2DM. Sample: 2328 patients, 582 per arm. Intervention: G1: Interventions on the patients: Educational and habit modification group program. G2: Intervention on the PHCT: a) Educative intervention to improve the knowledge about the disease and their abilities; b) Computer-based clinical decision support system; c) Feedback of results. G3: Interventions on the patients and the PHCT. G4: Control group. Patients receive only the usual care.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
2334
Inclusion Criteria

Patients:

  • T2DM diagnosis
  • aged between 18 and 65

Health professionals:

  • primary health care teams (PHCT) comprising a primary care physician and a nurse practitioner associated to a patient will be selected
  • must have a permanent position or a stable substitute position
Exclusion Criteria
  • peripheral vascular disease
  • diabetic nephropathy and/or chronic kidney disease
  • cognitive impairment, dementia
  • major depression
  • insufficient level of Spanish
  • to be pregnant or planning to become pregnant in the next 6 months
  • cancer last 5 years
  • ischemic disease or heart failure
  • proliferative diabetic retinopathy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention to PatientsIntervention to patientsOnly patients receive intervention
Mixed InterventionIntervention to patientsPatients and healthcare professionals (primary care physicians and nurses practitioners) associated with these patients receive intervention
Intervention to PatientsUsual careOnly patients receive intervention
ControlUsual carePatients receive usual care
Intervention to healthcare ProfessionalsIntervention to professionalsPrimary care physicians and nurses practitioners receive the intervention. Their associated patients do not receive direct intervention although indirect intervention through professionals
Intervention to healthcare ProfessionalsUsual carePrimary care physicians and nurses practitioners receive the intervention. Their associated patients do not receive direct intervention although indirect intervention through professionals
Mixed InterventionIntervention to professionalsPatients and healthcare professionals (primary care physicians and nurses practitioners) associated with these patients receive intervention
Mixed InterventionUsual carePatients and healthcare professionals (primary care physicians and nurses practitioners) associated with these patients receive intervention
Primary Outcome Measures
NameTimeMethod
Change in Glycosylated hemoglobin (HbA1c)Baseline and 12 months

Change in Glycosylated hemoglobin from baseline to 12 months

Secondary Outcome Measures
NameTimeMethod
Change in HDL levelBaseline and 6, 12 and 24 months
Change in LDL levelBaseline and 6, 12 and 24 months
Change in Total cholesterol levelBaseline and 6, 12 and 24 months
Medication administrationBaseline and 6, 12, 18 and 24 months

Initiation of new drugs or dosage adjustment: insulin, antidiabetics, hypolipidemics, antihypertensives, etc.

Change in WeightBaseline and 3, 6, 12, 18 and 24 months
Change in ADDQoL scoreBaseline and 6, 12, 18 and 24 months

ADDQoL is a specific questionnaire for health related quality of life (HRQL) assessment

Change in tabacco consumptionBaseline and 3, 6, 12, 18 and 24 months
Acceptability of interventions and satisfaction (INDICA-SATP)24 months
Change in Diabetes KnowledgeBaseline, 12 and 24 months
Change in Glycosylated hemoglobin (HbA1c)Baseline and 3, 6, 18 and 24 months
Change in Waist circumferenceBaseline and 3, 6, 12, 18 and 24 months
Change in Body Mass Index (BMI)Baseline and 3, 6,12, 18 and 24m
Change in International Physical Activity Questionnarie (IPAQ) scoreBaseline and 6, 12, 18 and 24 months
Change in Diabetes Empowerment Scale - Short Form (DES-SF) scoreBaseline, 12 and 24 months
Change in Basal glucoseBaseline and 3, 6, 12, 18 and 24 months
Change in EQ-5D indexBaseline and 6, 12, 18 and 24 months

EQ-5D is a generic questionnaire for health related quality of life (HRQL) assessment

Change in Mediterranean Diet Adherence Screener (MEDAS) scoreBaseline and 6, 12, 18 and 24 months
Change in Stait-Trait Anxiety Inventory (STAI) scoreBaseline, 12 and 24 months
Change in Beck Depression Inventory - II (BDI-II) scoreBaseline, 12 and 24 months
Change in Diabetes Distress Scale (DDS2) scoreBaseline, 12 and 24 months
Change in Morisky Compliance ScaleBaseline and 6, 12, 18 and 24 months
Change in TriglyceridesBaseline and 6, 12 and 24 months

Trial Locations

Locations (1)

Servicio de Evaluación del Servicio Canario de la Salud

🇪🇸

Santa Cruz de Tenerife, Spain

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