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Evaluation of a Toolkit to Improve Cardiovascular Disease Screening and Treatment for People With Diabetes

Not Applicable
Completed
Conditions
Diabetes Mellitus
Cardiovascular Disease
Interventions
Other: Toolkit
Other: Control
Registration Number
NCT01411865
Lead Sponsor
Sunnybrook Health Sciences Centre
Brief Summary

Diabetes is a common and serious chronic disease. However, there is a large gap between the level of care that people should receive (based on research and guidelines) and the level of care they actually receive. With the release of their 2008 Clinical Practice Guidelines, the Canadian Diabetes Association has a strategy to improve heart disease screening and treatment for people with diabetes. This study will evaluate whether the strategy works. The focus of the strategy was to give all family physicians in Canada a Toolkit in June 2009 to help them delivery better care for their diabetic patients. In Ontario, only half of doctors received this Toolkit. We will compare the quality of care received by diabetic patients whose doctors received this Toolkit versus those who doctors did not.

Detailed Description

A cardiovascular disease Toolkit was developed by the Canadian Diabetes Association and mailed to family physician with the Spring/Summer 2009 edition of the newsletter, Canadian Diabetes. The Toolkit was packaged in a brightly-coloured box with Canadian Diabetes Association branding, and contained: 1) an introductory letter from the Chair of the practice guidelines' Dissemination and Implementation Committee; 2) an eight page summary of selected sections of the practice guidelines targeted towards primary care physicians; 3) a four page synopsis of the key guideline elements pertaining to cardiovascular disease risk; 4) a small double-sided laminated card with a simplified algorithm for cardiovascular risk assessment, vascular protection strategies and screening for cardiovascular disease; and 5) a pad of tear-off sheets for patients with a cardiovascular risk self-assessment tool and a list of recommended risk reduction strategies.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
933789
Inclusion Criteria
  • Alive on 1 July 2009 with prevalent diabetes
Exclusion Criteria
  • Age <= 39
  • Residing in long-term care

Secondary Analysis:

  • Analysis will be repeated using all people alive on 1 July 2009 without prevalent diabetes using the same exclusion criteria, to determine the spill-over effect of the Intervention on physicians' other patients.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionToolkit-
ControlControl-
Primary Outcome Measures
NameTimeMethod
Death or non-fatal myocardial infarctionUp to 10 months
Secondary Outcome Measures
NameTimeMethod
Cardiac stress test or nuclear imagingUp to 10 months
Ambulatory cardiology or internal medicine visitUp to 10 months
Death, non-fatal myocardial infarction or non-fatal strokeUp to 10 months
Death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for unstable angina or transient ischemic attackUp to 10 months
Hospitalization for myocardial infarction or unstable anginaUp to 10 months
DeathUp to 10 months
Coronary angiographyUp to 10 months
Prescription for insulinUp to 10 months
Hospitalization for myocardial infarctionUp to 10 months
Hospitalization for strokeUp to 10 months
ElectrocardiogramUp to 10 months
Prescription for angiotensin converting enzyme inhibitor or angiotensin receptor blockerUp to 10 months
Prescription for at least three classes of antihypertensive agentsUp to 10 months
Prescription for nitrateUp to 10 months
Hospitalization for stroke or transient ischemic attackUp to 10 months
Prescription for at least two classes of antihypertensive agentsUp to 10 months
Prescription for any glucose-lowering drugUp to 10 months
Coronary revascularization procedureUp to 10 months
Prescription for at least one class of antihypertensive agentUp to 10 months
Prescription for statinUp to 10 months

Trial Locations

Locations (1)

Institute for Clinical Evaluative Sciences

🇨🇦

Toronto, Ontario, Canada

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