NCT01026688

Brief Summary

Diabetes is a common and serious chronic disease. However, there is a large gap between the level of care that people should receive (based on research and guidelines) and the level of care they actually receive. With the release of their 2008 Clinical Practice Guidelines, the Canadian Diabetes Association has a strategy to improve heart disease screening and treatment for people with diabetes. This study will evaluate whether the strategy works. The focus of the strategy was to give all family physicians in Canada a Toolkit in June 2009 to help them delivery better care for their diabetic patients. In Ontario, only half of doctors received this Toolkit. We will compare the quality of care received by diabetic patients whose doctors received this Toolkit versus those who doctors did not.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,592

participants targeted

Target at P75+ for not_applicable diabetes-mellitus

Timeline
Completed

Started Jun 2010

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 2, 2009

Completed
2 days until next milestone

First Posted

Study publicly available on registry

December 4, 2009

Completed
6 months until next milestone

Study Start

First participant enrolled

June 1, 2010

Completed
11 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2011

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2011

Completed
Last Updated

November 24, 2014

Status Verified

November 1, 2014

Enrollment Period

11 months

First QC Date

December 2, 2009

Last Update Submit

November 21, 2014

Conditions

Keywords

Pragmatic randomized controlled trialCardiovascular risk reductionKnowledge translationClinical practice guidelines

Outcome Measures

Primary Outcomes (1)

  • Patient is receiving a statin

    July 2009 to April 2010

Secondary Outcomes (10)

  • Patient is receiving an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker

    July 2009 to April 2010

  • A1c level

    Last observation between July 2009 and April 2010

  • Blood pressure level

    Last observation between July 2009 and April 2010

  • LDL-cholesterol level

    Last observation between July 2009 and April 2010

  • Total- to HDL-cholesterol ratio

    Last observation between July 2009 and April 2010

  • +5 more secondary outcomes

Study Arms (2)

Intervention

EXPERIMENTAL
Other: Toolkit

Control

OTHER
Other: Control

Interventions

ToolkitOTHER

Cardiovascular Disease Toolkit mailed by the Canadian Diabetes Association to family physicians, accompanying the Spring/Summer 2009 edition of the quarterly newsletter, Canadian Diabetes. (Mailed in June 2009.) The Toolkit includes a summary of selected sections of the practice guidelines targeted towards primary care physicians; a synopsis of the key messages pertaining to cardiovascular disease risk; a laminated card with a simplified algorithm for cardiovascular risk assessment and treatment; and a pad of tear-off sheets for patients with a cardiovascular risk self-assessment tool.

Intervention
ControlOTHER

The Spring/Summer 2009 issue of the quarterly newsletter, Canadian Diabetes, mailed on its own. The Cardiovascular Toolkit was mailed to Control arm physicians with the May 2010 issue of the newsletter.

Control

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patient with diagnosed diabetes
  • Seen in the office of a participating family physician at least once between July 2009 and April 2010
  • At high risk for cardiovascular events:
  • Previous cardiovascular disease (including AMI, angina, stroke, TIA, claudication); or
  • Men aged \>= 45 years, women aged \>= 50 years; or
  • Men aged \< 45 years, women aged \< 50 years with at least one of the following:
  • Macrovascular disease (silent myocardial infarction, or evidence of peripheral arterial, carotid or cerebrovascular disease)
  • Microvascular disease (nephropathy or retinopathy)
  • Family history of premature coronary or cerebrovascular disease in a first-degree relative
  • Duration of diabetes \> 15 years with age \> 30 years

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Institute for Clinical Evaluative Sciences

Toronto, Ontario, M4N 3M5, Canada

Location

Related Publications (2)

  • Shah BR, Bhattacharyya O, Yu CH, Mamdani MM, Parsons JA, Straus SE, Zwarenstein M. Effect of an educational toolkit on quality of care: a pragmatic cluster randomized trial. PLoS Med. 2014 Feb 4;11(2):e1001588. doi: 10.1371/journal.pmed.1001588. eCollection 2014 Feb.

    PMID: 24505216BACKGROUND
  • Shah BR, Bhattacharyya O, Yu C, Mamdani M, Parsons JA, Straus SE, Zwarenstein M. Evaluation of a toolkit to improve cardiovascular disease screening and treatment for people with type 2 diabetes: protocol for a cluster-randomized pragmatic trial. Trials. 2010 Apr 23;11:44. doi: 10.1186/1745-6215-11-44.

MeSH Terms

Conditions

Diabetes MellitusCardiovascular Diseases

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System Diseases

Study Officials

  • Baiju R Shah, MD PhD

    Institute for Clinical Evaluative Sciences

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

December 2, 2009

First Posted

December 4, 2009

Study Start

June 1, 2010

Primary Completion

May 1, 2011

Study Completion

May 1, 2011

Last Updated

November 24, 2014

Record last verified: 2014-11

Locations