Tertiary Prevention in Type II Diabetes Mellitus in Canary Islands Study
Condition: Type 2 Diabetes Mellitus
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      Objective:

        -  To improve health outcomes of patients with type 2 diabetes mellitus (T2DM) by
           influencing disease self-management through lifestyle modification and by helping
           primary care professionals to improve health care provided to patients.

        -  To assess the effectiveness and cost-effectiveness of two complex interventions
           (education and behavioural modification, independently and conjointly, for primary
           health care teams (PHCT) and patients and their relatives) to improve the health results
           in people with T2DM.

      Methodology:

      Design: Randomized clinical trial. Setting: Basic healthcare district in Canary Islands.
      Spain. Subjects: Patients with T2DM, 18-65 years old, without complications. Main measures:
      HbA1c, rate of patients with properly controlled T2DM. Sample: 2328 patients, 582 per arm.
      Intervention: G1: Interventions on the patients: Educational and habit modification group
      program. G2: Intervention on the PHCT: a) Educative intervention to improve the knowledge
      about the disease and their abilities; b) Computer-based clinical decision support system; c)
      Feedback of results. G3: Interventions on the patients and the PHCT. G4: Control group.
      Patients receive only the usual care.
    


Intervention name(s): Intervention to patients; Intervention to professionals; Usual care
Intervention type(s): Behavioral; Behavioral; Other
Intervention description(s): Multifaceted intervention consisting of:
Program of education and behavior modification: group sessions conducted by health educators for the patient and a relative (who usually do the food shopping or prepare meals) every 3 months over 2 years (total:8 sessions). Main contents: diabetes, hygiene/nutrition and physical exercise.
Monitoring of patient conditions by Informational Communication Technologies (ICT): patient will complete at home a web-based short questionnaire once a week and an expanded version once a month.
Short text messaging to patient's mobile based on information obtained from self-reported questionnaires. 3 types of messages: 1) Reminders for completing web-based questionnaires, the attendance at group sessions and the follow-up appointments, 2) General advice on good habits, 3) Custom messages to reinforce behavior change.; Multifaceted intervention consisting of:
Educational intervention: Two theoretical and practical sessions to update knowledge on T2DM management and provide professionals with techniques to enhance the patient-centered clinical relationship model and the shared decision making model with the ultimate goal of improving patient adherence to treatment and self-care.
Computer-based clinical decision support system (CDSS): Implementation of an automated tool combining evidence-based knowledge with patient-specific information to assist clinicians in making clinical decisions in the management of T2DM patients.
Feedback: periodic mailing of personalized feedback reports with data on health results of all T2DM patients who are cared by the professional.; Usual care for T2DM received in primary health care
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: diabetes; self-management; lifestyle; diet; physical exercise; computer-assisted decision support systems