Comparison Study of Usual Care vs. Usual Care Plus Community Intervention to Manage Type 2 Diabetes

NCT ID: NCT02158741

Last Updated: 2019-08-30

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

291 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-09-30

Study Completion Date

2017-05-31

Brief Summary

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The overall purpose of this research is to examine and compare the effectiveness and costs of a community-based intervention to support self-management with usual primary care for older adults with Type 2 Diabetes Mellitus and multiple chronic conditions and their family caregivers. Once the study is complete, the investigators will be able to determine if there is any measurable difference in self-care management between usual care plus the intervention versus usual care alone.

Detailed Description

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Research Goal

To examine the comparative effectiveness and costs of a community-based intervention to support self-management with usual primary care for older adults with T2DM and Multiple Chronic Conditions and their family caregivers.

Objectives

1. To determine if a 6-month, IP, community-based intervention improve self-management compared with usual primary care services?
2. To compare the effectiveness of the intervention on HRQoL, physical activity, nutritional status, depression, anxiety, diabetes parameters (blood glucose levels \[HbA1c, hypoglycemic episodes\]), diabetes-related complications, number of vascular events, social support number of falls, fall risk and medication safety with usual primary care services?
3. To determine the effectiveness of the intervention on HRQoL of family caregivers compared with usual primary care?
4. To assess whether or not the intervention improves clinical practice behaviours?
5. To determine the 6-month costs of use of health services of the intervention compared with usual care, from a social perspective?
6. To identify which subgroups of older adults with T2DM and MCC benefit most from the intervention?
7. To determine the effectiveness of the intervention based on sex/gender and region?
8. To determine the overall feasibility and acceptability of an IP community-based health promotion intervention and what can be identified as barriers and facilitators to implementation?

Conditions

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Type 2 Diabetes Mellitus NIDDM Non-insulin Dependent Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Usual Primary Care

Usual Primary Care will be received by half the participants during the course of the Study

Group Type NO_INTERVENTION

No interventions assigned to this group

Home Visits and educational support

Intervention comprised of Home Visits and group educational sessions. Home Visits and will be conducted by Diabetes Education staff in lieu of usual care conducted at the Diabetes clinic. Lifestyle support and educational will be offered in the form of monthly Diabetes Wellness Days offered in the community where nutrition, exercise and support will be given to help improve self-management of diabetes.

Group Type ACTIVE_COMPARATOR

Home Visits and Lifestyle Education Support

Intervention Type BEHAVIORAL

Interventions

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Home Visits and Lifestyle Education Support

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* older adults aged 65+
* live in the local vicinity of a participating Diabetes Education Program
* were referred to their Diabetes Education Program within the past 24 months
* competence in English (or access to a translator)
* intention to continue living in the area for the next 6 months
* two reported chronic conditions in addition to T2DM. Individuals with newly diagnosed T2DM as well as those who were already receiving treatment for T2DM will be eligible for inclusion in the study.

Exclusion Criteria

* score of 20 or less in Montreal Cognitive Assessment (MoCA) test AND without access to a substitute decision maker to sign consent (Score of 20 or less is not in itself an exclusion).
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ontario Ministry of Health and Long Term Care

OTHER_GOV

Sponsor Role collaborator

Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

McMaster University

OTHER

Sponsor Role lead

Responsible Party

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Maureen Markle-Reid

RN, PhD, Scientific Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Maureen Markle-Reid, PhD

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Jenny Ploeg, PhD

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Locations

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Edmonton Oliver PCN

Edmonton, Alberta, Canada

Site Status

Leduc Beaumont Devon PCN

Leduc, Alberta, Canada

Site Status

Sherwood Park PCN

Sherwood Park, Alberta, Canada

Site Status

McMaster University

Hamilton, Ontario, Canada

Site Status

Ross Memorial Hospital

Lindsay, Ontario, Canada

Site Status

St. Joseph's Health Care

London, Ontario, Canada

Site Status

Peterborough Regional Health Centre

Peterborough, Ontario, Canada

Site Status

Port Hope Community Health Centre

Port Hope, Ontario, Canada

Site Status

Countries

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Canada

References

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Markle-Reid M, Ploeg J, Fraser KD, Fisher KA, Bartholomew A, Griffith LE, Miklavcic J, Gafni A, Thabane L, Upshur R. Community Program Improves Quality of Life and Self-Management in Older Adults with Diabetes Mellitus and Comorbidity. J Am Geriatr Soc. 2018 Feb;66(2):263-273. doi: 10.1111/jgs.15173. Epub 2017 Nov 27.

Reference Type RESULT
PMID: 29178317 (View on PubMed)

Miklavcic JJ, Fraser KD, Ploeg J, Markle-Reid M, Fisher K, Gafni A, Griffith LE, Hirst S, Sadowski CA, Thabane L, Triscott JAC, Upshur R. Effectiveness of a community program for older adults with type 2 diabetes and multimorbidity: a pragmatic randomized controlled trial. BMC Geriatr. 2020 May 13;20(1):174. doi: 10.1186/s12877-020-01557-0.

Reference Type DERIVED
PMID: 32404059 (View on PubMed)

Markle-Reid M, Ploeg J, Valaitis R, Duggleby W, Fisher K, Fraser K, Ganann R, Griffith LE, Gruneir A, McAiney C, Williams A. Protocol for a program of research from the Aging, Community and Health Research Unit: Promoting optimal aging at home for older adults with multimorbidity. J Comorb. 2018 Jul 31;8(1):2235042X18789508. doi: 10.1177/2235042X18789508. eCollection 2018.

Reference Type DERIVED
PMID: 30191144 (View on PubMed)

Markle-Reid M, Ploeg J, Fraser KD, Fisher KA, Akhtar-Danesh N, Bartholomew A, Gafni A, Gruneir A, Hirst SP, Kaasalainen S, Stradiotto CK, Miklavcic J, Rojas-Fernandez C, Sadowski CA, Thabane L, Triscott JA, Upshur R. The ACHRU-CPP versus usual care for older adults with type-2 diabetes and multiple chronic conditions and their family caregivers: study protocol for a randomized controlled trial. Trials. 2017 Feb 6;18(1):55. doi: 10.1186/s13063-017-1795-9.

Reference Type DERIVED
PMID: 28166816 (View on PubMed)

Other Identifiers

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DRCT-06669

Identifier Type: -

Identifier Source: org_study_id

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