Structuring of Diabetes Care in Primary Health Care
Study Details
Study Description
Brief Summary
The aim of this study is to evaluate the effectiveness of reorganization in Primary Health Care teams and individualized glycemic targets for type 2 diabetes.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
The prevalence of diabetes is increasing in parallel with the obesity epidemic. Diabetes is, therefore, a costly disease for individuals and healthcare system, generating expenses in its management and its complications. Also, it has significant social cost related to reduction of productivity. This study will evaluate the effectiveness of a multimodal intervention for Primary Health Care (PHC) teams to increase the nurse clinical role and implement individualized glycemic targets and care plan for type 2 diabetes through a pragmatic cluster-randomized clinical trial, with 1:1 allocation of health units in Porto Alegre, Brazil. Two study arms will be evaluated: 1) intervention group: will receive a set of proposed actions (redistribution of diabetes care between nurses and physicians, use of the individualized glycemic target calculator and implementation of care recommendations); 2) control group: usual follow-up in PHC.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Intervention Multimodal intervention in the primary care team that includes: redistribution of diabetes care between nurses and physicians, use of the individualized glycemic target calculator and implementation of minimum care recommendations |
Other: Redistribution of diabetes care between nurses and physicians
It will be proposed that nurses and physician share the clinical care of patients with type 2 diabetes, with complementing actions
Other: Individualized glycemic target
Define the target of individualized glycemic treatment for patients with the support of a tool on the website, which will encourage the intensification and de-intensification of treatment when appropriate
Other: Minimum care recomendations
It will be proposed to carry out the minimum necessary assessments that, annually, nurses and physicians must do to ensure the adequacy of quality indicators in the care of diabetes in the PHC
|
| Active Comparator: Control Usual follow-up in Primary Health Care (no intervention in the teams) |
Other: No intervention
Primary care health teams will follow their rotine care of type 2 diabetes
|
Outcome Measures
Primary Outcome Measures
- Number of patients who achieved individualized target HbA1c [12 months]
Number of patients who achieved the individualized target HbA1c defined at baseline
Secondary Outcome Measures
- Percentage of clinical consultations carried out by nurses [12 months]
Proportion of nursing consultations in relation to the total number of consultations (nurse and physician)
- Foot evaluation [12 months]
Total number of nursing consultations in which the feet were evaluated
Eligibility Criteria
Criteria
Health care unit:
Inclusion criteria
- Health unit has registered at least 50 users diagnosed with type 2 diabetes
Exclusion criteria:
- Health units that do not have a doctor and a nurse available on the same shift or do not have at least one doctor and a nurse willing to participate in the study.
Individuals:
Inclusion criteria
-
Individuals with type 2 diabetes for at least one year
-
In person diabetes consultation in the last six months
Exclusion criteria:
- Expected survival < one year
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Ana Maria Frölich Matzenbacher | Porto Alegre | Rio Grande Do Sul | Brazil | 90035003 |
Sponsors and Collaborators
- Hospital de Clinicas de Porto Alegre
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
Investigators
- Principal Investigator: Beatriz Schaan, UFRGS e HCPA
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 20220197
- 64538322.1.0000.5327