Diabetes Mellitus, Type 2
Conditions
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.
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.
Interventions
OTHERRedistribution 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
OTHERIndividualized 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
OTHERMinimum 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
OTHERNo intervention
Primary care health teams will follow their rotine care of type 2 diabetes
Sponsors
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Hospital de Clinicas de Porto Alegre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Cluster randomized clinical trial
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion 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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients who achieved individualized target HbA1c | 12 months | Number of patients who achieved the individualized target HbA1c defined at baseline |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 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 |
Countries
Brazil
Contacts
Primary ContactBeatriz Schaan
Backup ContactAna Matzenbacher
Outcome results
None listed