Nurse-led Continuum of Care for People With Diabetes and Pre-diabetes in Nepal

NCT ID: NCT04131257

Last Updated: 2019-10-18

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

1236 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-31

Study Completion Date

2020-12-31

Brief Summary

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The study aims to improve diabetes prevention, access to care and advocacy through a novel cost-effective nurse-led continuum of care approach that incorporates diabetes prevention, awareness, screening and management for low-income settings, and furthermore utilizes the endeavor to advocate for establishing standard diabetes program in Nepal.

Detailed Description

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The purpose of this study will be to improve diabetes prevention, access to care and advocacy through a novel cost-effective nurse-led continuum of care approach that incorporates diabetes prevention, awareness, screening and management for low-income settings, and furthermore utilizes the endeavor to advocate for establishing standard diabetes program in Nepal.

We will conduct a two-arm, open-masked stratified cluster randomized controlled trial of a NUrse-led COntinuum of care for people with diabetes and pre-diabetes (NUCOD), with primary care centers (Outreach centers and Government health posts) as a unit of randomization. NUCOD will be delivered through the trained diabetes nurses in the community to the intervention group and the outcomes will be compared to the enhanced usual-treatment group at 6 and 12 months of the intervention. The primary outcome will be change in glycated hemoglobin (HbA1c) level among diabetes and progression to type 2 diabetes among pre-diabetes, and implementation outcomes measured using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Outcomes will be analyzed on an intention to treat basis.

The results of this trial will provide information about the effectiveness of the NUCOD program in improving clinical outcomes for diabetes and pre-diabetes individuals, and implementation outcomes for the organization.

Conditions

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Diabetes Mellitus, Type 2

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors

Study Groups

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Continuum of care

Trained diabetes nurses will provide continuum of care to the participants that includes: conducting community awareness campaigns, screening programs, linkage to clinical care, community follow-up counseling and support for individuals with diabetes, and prevention programs for individuals with pre-diabetes.

Group Type EXPERIMENTAL

Nurse-led Continuum of Care

Intervention Type BEHAVIORAL

This will be a nurse-led community level prevention program for individuals with diabetes and pre-diabetes, where participants in intervention group will receive nurse-led continuum of care while control group will receive usual diabetic care.

Usual care

The control group will receive usual diabetic care without the nurse coordination and supervision as in the intervention group.

Group Type ACTIVE_COMPARATOR

Nurse-led Continuum of Care

Intervention Type BEHAVIORAL

This will be a nurse-led community level prevention program for individuals with diabetes and pre-diabetes, where participants in intervention group will receive nurse-led continuum of care while control group will receive usual diabetic care.

Interventions

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Nurse-led Continuum of Care

This will be a nurse-led community level prevention program for individuals with diabetes and pre-diabetes, where participants in intervention group will receive nurse-led continuum of care while control group will receive usual diabetic care.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* with confirmed pre-existing type II diabetes and prediabetes at the time of our screening (i.e., pre-existing diabetes or prediabetes)
* with confirmed diagnosis of type II diabetes or prediabetes after our community screening process (i.e., newly diagnosed diabetes and prediabetes)
* is not planning to relocate outside of the current place of living in next 2 years
* is older than 18 years of age

Exclusion Criteria

* are not psychologically capable of communication
* are diagnosed as type 1 diabetes
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Kathmandu University School of Medical Sciences

OTHER

Sponsor Role lead

Responsible Party

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Biraj Man Karmacharya

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Biraj M Karmacharya, PhD

Role: PRINCIPAL_INVESTIGATOR

Kathmandu University School of Medical Sciences

Central Contacts

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Biraj M Karmacharya

Role: CONTACT

+977 9802000029

Rubee Dev

Role: CONTACT

+86 15521049506

References

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Xu DR, Dev R, Shrestha A, Zhang L, Shrestha A, Shakya P, Hughes JP, Shakya PR, Li J, Liao J, Karmacharya BM. NUrse-led COntinuum of care for people with Diabetes and prediabetes (NUCOD) in Nepal: study protocol for a cluster randomized controlled trial. Trials. 2020 May 29;21(1):442. doi: 10.1186/s13063-020-04372-5.

Reference Type DERIVED
PMID: 32471476 (View on PubMed)

Other Identifiers

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KathmanduUSMS

Identifier Type: -

Identifier Source: org_study_id

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