Type 2 diabetes Nutritional, Metabolic, Endocrine
Conditions
Interventions
Participants in the intervention arm will receive the care using a shared decision-making pharmacist care pathway approach designed to guide type 2 diabetes management to achieve target A1C levels and
Sponsors
University of Alberta
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: 1. Individuals aged 18 years or older 2. Individuals with type 2 diabetes, further assessed to rule out latent autoimmune diabetes in adults (LADA) or maturity onset diabetes of the young (MODY) by asking patients: “Do you have diabetes that does not require the use of insulin, or did not require the ongoing consistent use of insulin immediately after diagnosis for more than 6 months after diagnosis” AND “Did you develop diabetes as a result of damage to the pancreas such as acute/chronic pancreatitis, or pancreatic surgery?” 3. Individuals with type 2 diabetes not reaching HbA1c target of =7.0%
Exclusion criteria
Exclusion criteria: 1. Individuals with type 1 diabetes, gestational diabetes, or other forms of diabetes that are not type 2 diabetes 2. Pregnant individuals 3. Individuals at their HbA1c target (HbA1c =7.0%) or those with a limited life expectancy, frailty, or lack hypoglycemic awareness (i.e., those with an A1c target >7.0%) 4. Individuals unable to provide consent or who are unwilling to attend follow-up visits
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Glycemic control measured using A1C at baseline and at 6 months | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Cardiovascular risk measured using the EPIRISK calculator at baseline and at 6 months 2. Blood pressure measured using a standardized blood pressure monitor at baseline and at 6 months 3. LDL measured using a standardized lipid panel at baseline and at 6 months 4. Number of patients completing influenza and pneumococcal immunization measured by assessment of patient records at 6 months 5. Number of patients who completed annual foot exams, eye exams, and kidney function screening measured by assessment of patient records at 6 months 6. Number of patients who have appropriate vascular protection in place measured by assessment of patient records at 6 months 7. Types of interventions provided by the pharmacists including education on lifestyle factors (tobacco cessation, diet, exercise), prescribing or changing the dose of medications, education on new or changed medications, education on adherence to medications and/or lifestyle recommendations measured by assessment of patient records at 6 months 8. The percentage of individuals who attended their scheduled laboratory assessments measured by assessment of patient records at 6 months 9. The percentage of individuals who use continuous glycose monitoring devices as part of their type 2 diabetes management measured by assessment of patient records at 6 months 10. Patient satisfaction as measured by the diabetes treatment satisfaction questionnaire standard and change at baseline and at 6 months 11. Extent to which shared decision making was achieved in the intervention as measured by the validated Shared Decision Making 9-item Questionnaire (SDM-Q-9) tool at 6 months | — |
Countries
Canada
Contacts
Public ContactStephanie Gysel
Outcome results
None listed