Patient Activation Through Community Empowerment/Engagement for Diabetes Management (PACE-D)
NCT ID: NCT04288362
Last Updated: 2022-04-26
Study Results
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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COMPLETED
NA
1620 participants
INTERVENTIONAL
2019-03-25
2022-03-31
Brief Summary
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Detailed Description
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In the intervention group, patients recruited will undergo the new care model which entails receiving the Care Planning Results Letter before the consultation at their annual review, involving them in the Care and Support Planning (CSP) consultation at the annual review, and referring them to suitable community resources to support self-management. The Care Planning Results Letter prompts patients to think the issues they would like to raise to their Doctor or Care Manager (who is a nurse trained in chronic disease management), checks on their mood, provides information on their most recent few laboratory test results, clinical parameters, smoking status, and attendances for foot and eye screenings. The letter also covers goal setting and action planning discussions. The patient is expected to bring it for the upcoming CSP consultation at the annual review. The CSP is a conversation which is conducted by the Doctor or Care Manager trained in the new care model. It focuses on a collaborative approach between the health care providers and the patient for joint goal setting and shared decision making to support self-management of their chronic condition(s).
In the control arm, the participants will receive the usual care with the teamlet model. There will not be any Care Planning Results Letter prepared for the patient. At the upcoming annual visit, the patient will continue to have the usual annual review for the laboratory test results and consultation. A flyer that lists the community programmes that support the patient for self-management will also be issued to the patient. If the patient is interested in any of these programmes, they may sign up with the respective community providers directly.
After the first CSP, selected patient participants may be invited for a one-to-one in-depth interviews (IDIs) to explore their perceptions about diabetes, diabetes management and the intervention programme in greater detail. The interviews will be conducted by researchers trained qualitative research methodology. They will be semi-structured with a topic guide to support exploration of the themes of interest, and will be informed by prior qualitative research with this and other similar interventions, as well as the results from the patient surveys. Health care providers who are involved in the delivery of CSPs in the intervention arm will also be invited for a one-to-one in-depth interviews (IDIs), to develop an understanding of how they find the training and new way of working with patients (particularly the care and support planning conversation).
Conditions
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Study Design
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NON_RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Intervention Group
Intervention Group
Participants in this arm will undergo the new care model for management of diabetes mellitus polyclinics.
Control Group
Control Group
Participants in this arm will continue to undergo the existing care model for management of diabetes mellitus in the polyclinics.
Interventions
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Intervention Group
Participants in this arm will undergo the new care model for management of diabetes mellitus polyclinics.
Control Group
Participants in this arm will continue to undergo the existing care model for management of diabetes mellitus in the polyclinics.
Eligibility Criteria
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Inclusion Criteria
* Adults with diabetes mellitus
* Age 21 years and above
* Ability to provide informed consent
* Ability to communicate in the language(s) which the physician is confident to carry out the care and support planning consult in English, Malay or Chinese
* Ability to read and comprehend the Diabetes Results Letter on their own OR has family members who are able to assist to that
Exclusion Criteria
* Age 21 years and above
* Ability to provide informed consent
21 Years
99 Years
ALL
No
Sponsors
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National University Hospital, Singapore
OTHER
National University of Singapore
OTHER
National University Health System, Singapore
OTHER
Responsible Party
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Tan Wee Hian
PACE-D Programme Director, Consultant Family Physician
Principal Investigators
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Doris Young
Role: STUDY_CHAIR
National University Health System, Singapore
Victor Weng Keong Loh
Role: STUDY_DIRECTOR
National University Health System, Singapore
Tong Wei Yew
Role: STUDY_DIRECTOR
National University Hospital, Singapore
Kavita Venkataraman
Role: STUDY_DIRECTOR
National University of Singapore
Brent Gibbons
Role: STUDY_DIRECTOR
National University of Singapore
Vikki Entwistle
Role: STUDY_DIRECTOR
National University of Singapore
Soon Guan Tan
Role: STUDY_DIRECTOR
National University of Singapore
Meena Sundram
Role: STUDY_DIRECTOR
National University Health System, Singapore
Keith Tsou
Role: STUDY_DIRECTOR
National University Health System, Singapore
Yii Jen Lew
Role: STUDY_DIRECTOR
National University Health System, Singapore
Wee Hian Tan
Role: PRINCIPAL_INVESTIGATOR
National University Health System, Singapore
Locations
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National University Polyclinics
Singapore, , Singapore
Countries
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References
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Coulter A, Entwistle VA, Eccles A, Ryan S, Shepperd S, Perera R. Personalised care planning for adults with chronic or long-term health conditions. Cochrane Database Syst Rev. 2015 Mar 3;2015(3):CD010523. doi: 10.1002/14651858.CD010523.pub2.
Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q. 1996;74(4):511-44.
Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002 Oct 16;288(15):1909-14. doi: 10.1001/jama.288.15.1909.
Hibbard JH, Stockard J, Mahoney ER, Tusler M. Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004 Aug;39(4 Pt 1):1005-26. doi: 10.1111/j.1475-6773.2004.00269.x.
Tan WH, Loh VWK, Venkataraman K, Choong ST, Lew YJ, Sundram M, Tsou K, Tan SG, Gibbons B, Entwistle V, Young D, Tai ES, Yew TW. The Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) protocol: a non-randomised controlled trial of personalised care and support planning for persons living with diabetes. BMC Fam Pract. 2020 Jun 19;21(1):114. doi: 10.1186/s12875-020-01173-2.
Other Identifiers
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CS-SN-03
Identifier Type: -
Identifier Source: org_study_id
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