Trial Comparing Care in Multiple Clinics Versus Care in a Cardiac, Diabetes and Kidney Care Clinic

Study Overview
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Brief Summary
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The purpose of this study is to assess the benefits of a combined cardiac, kidney, and diabetes clinic versus multiple clinics. Hypothesis: Attendance at multiple clinics by one individual patient has multiple problems which may be overcome by the introduction of a combined care clinic.

Detailed Description
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This is a randomized control trial to compare health care resource utilization, and achievement of stated targets of therapy (BP, Hgb, glucose control, use of preventive medications) as well as patient and health care team satisfaction, and longer term patient outcomes in patients with kidney disease who have either or both diabetes and heart disease, and currently attend either a diabetic or heart function clinic (or both) in addition to a kidney care clinic. In addition, we will also establish and refine the specialized cross-disciplinary care model, within a framework in Vancouver, and evaluate its functioning from the perspectives of allied health and medical professionals. This is a systematic evaluation of health care delivery methods to a complex group of patients, which will serve as a nidus for ongoing research in both health outcomes research, and biomedical research. The creation of this multifaceted clinic in an organized manner would permit evaluation of all of the components of it, and also demonstrate the importance of collaboration between disciplines and between public health care initiatives and industry partners, who would fund this clinic infrastructure and research components in the initial phase.

Official Title
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Randomized Controlled Trial Comparing Current Care in Multiple Clinics Vs Care in a Novel Cardiac, Diabetes & Kidney Care Clinic

Conditions
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Kidney Diseases, Heart Diseases, Diabetes Mellitus

Intervention / Treatment
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* Procedure: The Combined Cardiac Kidney Diabetes Care Clinic


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients currently attending or who would be eligible to attend 2 or more of the following clinics: cardiac, diabetic or kidney Exclusion Criteria: Those patients currently attending the diabetic, cardiac or kidney clinics who do not have more than one condition (i.e. who have only one of the diagnoses) or who refuse to sign informed consent

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: The Combined Cardiac Kidney Diabetes Care Clinic|See Detailed Description.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health care utilization and patient/provider satisfaction (5 years) |  | 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient outcomes (5 years) |  | 5 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Combined Clinic, Chronic Kidney Disease, Diabetes