Type 2 diabetes with or without albuminuria Non Communicable Disease,
Conditions
Interventions
SDHOs randomised to the intervention group will receive the SMARThealth Diabetes program described above. In brief,
they will receive:
1. a workforce restructuring and training programme: Training for community nurse and doctor will involve guidance in the use of the electronic data,
interpretation of the decision support output and advice on how to access and use audit and feedback activities. Locally appropriate remuneration for implementation of this programme will be a compone
doctors and community nurses will each be provided with a 7-
inch tablet with the SMARTHealth software.
(2) Clinical Decision Support System: The CDSS will incorporate components related to referral,
treatment and follow-
up applications for doctors and community nurses. The application will focus on personalised recommendations about blood glucose control,
blood pressure lowering,
ACE inhibition,
statin and anti-
platelet therapy
eye and foot care and the management of hypoglycaemia,
referral and follow-
up.
(3) Continuous performance monitoring: The performance of health workers and primary care doctors will be monitored using standard,
automated reports generated in real time and based on certain key performance indicators (e.g. the proportion of individuals with CKD on recommended combination treatment). These reports will be provi
without access to the training and support package,
the CDSS and associated tools.
In SDHOs where doctors are available,
the doctors will treat the type 2 DM patients by themselves wit
Experimental Device,No Intervention Other
SMARThealth Diabetes,Conventional Care
Sponsors
Medical Research Council
National Science and Technology Development Agency,Thailand Research Fund
Eligibility
Sex/Gender
All
Age
30 Years to 70 Years
Inclusion criteria
Inclusion criteria: Patients will be eligible to participate if they are - aged 30 to 70 years, - have established diabetes or identified to have diabetes in the initial screening by the frontline health workers or have eGFR values of > 60 ml/min/1.73 m2.
Exclusion criteria
Exclusion criteria: The following patients will not be eligible to participate: - Known ADPKD, lupus nephritis, obstructive uropathy, renal stone, nephrotic syndrome or primary glomerular disease. - Known advanced cancer (life expectancy < 2years) - Known AIDS. - Known pregnancy. - Patients have communication problems e.g. migrant workers, dementia.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Technology-aided management of diabetes and kidney disease by health workers in the community 1 year mg/DL | — |
Secondary
| Measure | Time frame |
|---|---|
| Progression of albuminuria 1 year μg/mg,eGFR 1 year mL/min/1.73m2,Systolic blood pressure 1 year mmHg,LDL cholesterol 1 year mg/DL,Proportion of HbA1c <7% 1 year gm%,Proportion of SBP <140 ! year mmHg | — |
Countries
Thailand
Contacts
Public ContactMethee Chanpitakkul
Bhumirajanagarindra Kidney Institute
Outcome results
None listed