Evaluation of a Toolkit to Improve Cardiovascular Disease Screening and Treatment for People With Diabetes
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 933,789
- 试验地点
- 2
- 主要终点
- Death or non-fatal myocardial infarction
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 40 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Alive on 1 July 2009 with prevalent diabetes
排除标准
- •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.
结局指标
主要结局
Death or non-fatal myocardial infarction
时间窗: Up to 10 months
次要结局
- Death, non-fatal myocardial infarction or non-fatal stroke(Up to 10 months)
- Death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for unstable angina or transient ischemic attack(Up to 10 months)
- Hospitalization for myocardial infarction or unstable angina(Up to 10 months)
- Death(Up to 10 months)
- Cardiac stress test or nuclear imaging(Up to 10 months)
- Ambulatory cardiology or internal medicine visit(Up to 10 months)
- Coronary angiography(Up to 10 months)
- Prescription for insulin(Up to 10 months)
- Hospitalization for myocardial infarction(Up to 10 months)
- Hospitalization for stroke(Up to 10 months)
- Electrocardiogram(Up to 10 months)
- Prescription for angiotensin converting enzyme inhibitor or angiotensin receptor blocker(Up to 10 months)
- Prescription for at least three classes of antihypertensive agents(Up to 10 months)
- Prescription for nitrate(Up to 10 months)
- Prescription for any glucose-lowering drug(Up to 10 months)
- Hospitalization for stroke or transient ischemic attack(Up to 10 months)
- Prescription for at least two classes of antihypertensive agents(Up to 10 months)
- Coronary revascularization procedure(Up to 10 months)
- Prescription for at least one class of antihypertensive agent(Up to 10 months)
- Prescription for statin(Up to 10 months)