Tailored Support for Type 2 Diabetes Patients With an Acute Coronary Event After Discharge From Hospital

NCT ID: NCT01801631

Last Updated: 2014-07-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

201 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-10-31

Study Completion Date

2013-12-31

Brief Summary

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Background: In type 2 diabetes mellitus patients, an acute coronary event (ACE) may result in a decreased quality of life and increased distress. According to the American Diabetes Association, transition from the acute care setting is a high-risk time for all patients, but tailored support specific to diabetes is scarce in that period. The investigators developed an intervention by a diabetes nurse to help diabetic patients reduce distress after their first ACE. The intervention is based on Bandura's Social Cognitive Theory, Leventhal's Common Sense Model, and on results of focus groups which were conducted to define the needs and wishes of type 2 diabetes patients and their partners regarding professional support after an ACE. The aim of this study is to evaluate the effectiveness of the intervention to reduce distress. The hypothesis is that patients who receive the intervention will have less diabetes related distress compared to the control group.

Methods/Design: Randomized controlled trial. Patients will be recruited directly after discharge from hospital. A diabetes nurse will visit the patients in the intervention group (n = 100) within three weeks after discharge from hospital, two weeks later and two months later. The control group (n = 100) will receive a telephone consultation. The primary outcome is diabetes related distress, measured with the Problem Areas in Diabetes questionnaire (PAID). Secondary outcomes are quality of life, anxiety, depression, HbA1c, blood pressure and lipids. Mediating variables are self-management, self-efficacy and illness representations. Variables will be measured with questionnaires directly after discharge from hospital and five months later. Biomedical variables will be obtained from the records from the primary care physician and the hospital. Differences between groups in change over time will be analyzed according to the intention-to-treat principle.

Discussion: Type 2 diabetes patients who experience a first ACE need tailored support after discharge from the hospital. This trial will provide evidence of the effectiveness of a supportive intervention to reduce distress in these patients.

Detailed Description

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See citation design paper

Conditions

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Type 2 Diabetes Acute Coronary Event

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Home visits

In addition to usual care the patients will receive three home visits from a trained diabetes nurse. The first visit (65 minutes) is within three weeks after discharge from the hospital; the second visit (45 minutes) is two weeks later and the third visit (45 minutes) is two months after the second home visit.

Group Type EXPERIMENTAL

Home visits

Intervention Type OTHER

In addition to usual care the patients will receive three home visits from a trained diabetes nurse. The first visit (65 minutes) is within three weeks after discharge from the hospital; the second visit (45 minutes) is two weeks later and the third visit (45 minutes) is two months after the second home visit.

Consultation by telephone

In addition to usual care patients will receive a consultation by telephone within three weeks after discharge to offer them personal attention. In this consultation they will get the opportunity to discuss in ten to fifteen minutes how they feel in the period after discharge.

Group Type OTHER

Consultation by telephone

Intervention Type OTHER

In addition to usual care patients will receive a consultation by telephone within three weeks after discharge to offer them personal attention. In this consultation they will get the opportunity to discuss in ten to fifteen minutes how they feel in the period after discharge.

Interventions

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Home visits

In addition to usual care the patients will receive three home visits from a trained diabetes nurse. The first visit (65 minutes) is within three weeks after discharge from the hospital; the second visit (45 minutes) is two weeks later and the third visit (45 minutes) is two months after the second home visit.

Intervention Type OTHER

Consultation by telephone

In addition to usual care patients will receive a consultation by telephone within three weeks after discharge to offer them personal attention. In this consultation they will get the opportunity to discuss in ten to fifteen minutes how they feel in the period after discharge.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* History of type 2 diabetes (\>1 year)
* Discharged from the hospital after a first acute coronary event defined as a Myocardial Infarction (MI), Coronary Artery Bypass Graft (CABG) procedure or Percutaneous Transluminal Coronary Angioplasty (PTCA)
* Sufficient knowledge of the Dutch language

Exclusion Criteria

* A serious illness or condition which will prevent full participation
* Not able to fill in questionnaires
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dutch Diabetes Research Foundation

OTHER

Sponsor Role collaborator

UMC Utrecht

OTHER

Sponsor Role lead

Responsible Party

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Prof. G.E.H.M. Rutten

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Guy E. Rutten, Professor

Role: PRINCIPAL_INVESTIGATOR

UMC Utrecht

Locations

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Meander Medical Center

Amersfoort, , Netherlands

Site Status

Gelre Hospitals

Apeldoorn, , Netherlands

Site Status

Lievensberg Hospital

Bergen op Zoom, , Netherlands

Site Status

Amphia Hospital

Breda, , Netherlands

Site Status

Gemini Hospital

Den Helder, , Netherlands

Site Status

Admiraal de Ruyter Hospital

Goes, , Netherlands

Site Status

Beatrix Hospital

Gorinchem, , Netherlands

Site Status

Westfriesgasthuis

Hoorn, , Netherlands

Site Status

Sint Antonius Hospital

Nieuwegein, , Netherlands

Site Status

Canisius Wilhelmina Hospital

Nijmegen, , Netherlands

Site Status

Diakonessenhuis

Utrecht, , Netherlands

Site Status

Sint Antonius Hospital

Utrecht, , Netherlands

Site Status

University Medical Center

Utrecht, , Netherlands

Site Status

Countries

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Netherlands

References

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Kasteleyn MJ, Gorter KJ, Stellato RK, Rijken M, Nijpels G, Rutten GE. Tailored support for type 2 diabetes patients with an acute coronary event after discharge from hospital - design and development of a randomised controlled trial. Diabetol Metab Syndr. 2014 Jan 18;6(1):5. doi: 10.1186/1758-5996-6-5.

Reference Type BACKGROUND
PMID: 24438342 (View on PubMed)

Kasteleyn MJ, Gorter KJ, van Puffelen AL, Heijmans M, Vos RC, Jansen H, Rutten GE. What follow-up care and self-management support do patients with type 2 diabetes want after their first acute coronary event? A qualitative study. Prim Care Diabetes. 2014 Oct;8(3):195-206. doi: 10.1016/j.pcd.2013.12.001. Epub 2014 Jan 3.

Reference Type BACKGROUND
PMID: 24389352 (View on PubMed)

Other Identifiers

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Dutch trial registration

Identifier Type: REGISTRY

Identifier Source: secondary_id

DF2009-70

Identifier Type: -

Identifier Source: org_study_id

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