NCT02002143

Brief Summary

Type 2 diabetes is a major problem of older people; its prevalence is greater than 20% in those aged over 65 years. Treatment such as medication, healthy nutritional choices \& body weight management, as well as physical activity can reduce the impact of diabetes. Older patients with type 2 diabetes can potentially benefit from Group Appointments, in which 8-12 patients share one appointment of about 60-120 minutes with a team of health professionals. The team of investigators (3 people) will see the 'Group' 4 times/yr for two years. Their key measure of success will be control of glycosylated hemoglobin - HbA1C. To address their primary and secondary research objectives the investigators will focus upon patients aged 65 years or older who have T2DM and who are being treated with oral hypoglycemic agents and diet, or diet alone. The investigators will compare patients randomized to (A) eight Group Appointments over a 24 month period (i.e., 4 per year), led by a primary care physician \[Intervention\] with, (B) patients randomized to eight traditional one-to-one usual care appointments also provided by a primary care physician (Individual Appointment; \[Control\]). The investigators will compare (A) and (B) on selected clinical, patient-rated, and economic outcome measures. SIGNIFICANCE: Seven Canadian provinces already have Group Appointment billing codes for physicians who lead Group Appointments. If the study's proposed health care innovation demonstrates benefits, it would be possible to 'roll out' / 'scale up' the model province- or nation-wide in Primary Care settings.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
128

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2014

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
unknown

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

November 28, 2013

Completed
7 days until next milestone

First Posted

Study publicly available on registry

December 5, 2013

Completed
27 days until next milestone

Study Start

First participant enrolled

January 1, 2014

Completed
5.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2019

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2020

Completed
Last Updated

November 22, 2017

Status Verified

November 1, 2017

Enrollment Period

5.1 years

First QC Date

November 28, 2013

Last Update Submit

November 20, 2017

Conditions

Type 2 Diabetes Mellitus (T2DM)

Keywords

DiabetesOlder PeopleSeniorsGroup AppointmentsGroup Medical VisitsShared AppointmentsQuality of LifePhysical ActivityHealth care UtilizationDepressionAnxiety

Outcome Measures

Primary Outcomes (1)

  • Patients' control (decreased levels) of HemoglobinA1C (clinical)

    The investigators will measure Hemoglobin A1C (%, primary outcome), utilizing the phlebotomy unit in the CHHM Mobile Lab to collect a non-fasting blood sample (standard techniques). They will request that study participants not engage in any physical activity, or consume alcohol/caffeine 24 hours prior to measurement. Collected samples will be refrigerated in the Mobile Lab and transported the same day to the Vancouver General Hospital Pathology Lab for analysis as per current standard methods.

    Changes from baseline at 24 months

Secondary Outcomes (60)

  • Resting systolic blood pressure (mmHg)) (clinical)

    Changes from baseline at 12 months

  • Resting systolic blood pressure (mmHg)) (clinical)

    Changes from baseline at 24 months

  • Resting systolic blood pressure (mmHg)) (clinical)

    Changes from baseline at 36 months (1-year post-intervention)

  • Resting diastolic blood pressure (mmHg)) (clinical)

    Changes from baseline at 12 months

  • Resting diastolic blood pressure (mmHg)) (clinical)

    Changes from baseline at 24 months

  • +55 more secondary outcomes

Study Arms (2)

Individual Appointments (IAs)

ACTIVE COMPARATOR

Participants randomly assigned to the "IAs" group will receive eight traditional 1-to-1 appointments, seeing their physician quarterly as per standard care in BC. They will be referred to ancillary services such as nutrition advice, counseling, and physical activity promotion according to 'usual care' practice. In addition, we will organize 4 1-hour social events for these participants annually. The 4 social events will be 1) a potluck lunch; 2) a movie night; 3) an event chosen by participants; and 4) a talent show. From our experience, these events enhance compliance to reporting and minimize dropouts. These events also serve to minimize 'socialization bias' that may otherwise potentially influence health measures including quality of life.

Behavioral: Individual Appointments (IAs)

Group Appointments (GAs)

EXPERIMENTAL

Participants randomly assigned to the intervention group will participate in GAs of 8 patients for 1.5 hours, every 3 months for 2 years. The 3-member Care Team (MD, nurse, behaviorist) will attend each session. The nurse facilitates the session and curriculum. The MD responds to specific health questions. Patients may schedule time before or after to review their clinical results with the MD/nurse (e.g. HbAIC). Key elements include 1) completed pre-appt questionnaires used to identify a patient's educational needs; 2) patients use goal setting and action plans to initiate and maintain healthy behaviors; 3) each class has a designated purpose and learning objectives; 4) sessional feedback, which is used to adapt the next class (3 months later) based on patient needs.

Behavioral: Group Appointments

Interventions

Group AppointmentsBEHAVIORAL

Participants randomly assigned to the intervention group will participate in GAs of 8 patients for 1.5 hours, every 3 months for 2 years. The 3-member Care Team (MD, nurse, behaviorist) will attend each session. The nurse facilitates the session and curriculum. The MD responds to specific health questions. Patients may schedule time before or after to review their clinical results with the MD/nurse (e.g. HbAIC). Key elements include 1) completed pre-appt questionnaires used to identify a patient's educational needs; 2) patients use goal setting and action plans to initiate and maintain healthy behaviors; 3) each class has a designated purpose and learning objectives; 4) sessional feedback, which is used to adapt the next class (3 months later) based on patient needs.

Also known as: Shared Appointments, Group Medical Visits
Group Appointments (GAs)
Individual Appointments (IAs)BEHAVIORAL

Participants randomly assigned to the "IAs" group will receive eight traditional 1-to-1 appointments, seeing their physician quarterly as per standard care in BC. They will be referred to ancillary services such as nutrition advice, counseling, and physical activity promotion according to 'usual care' practice. In addition, we will organize 4 1-hour social events for these participants annually. The 4 social events will be 1) a potluck lunch; 2) a movie night; 3) an event chosen by participants; and 4) a talent show. From our experience, these events enhance compliance to reporting and minimize dropouts. These events also serve to minimize 'socialization bias' that may otherwise potentially influence health measures including quality of life.

Individual Appointments (IAs)

Eligibility Criteria

Age65 Years+
Sexall
Healthy VolunteersYes
Age GroupsOlder Adult (65+)

You may qualify if:

  • aged ≥ 65 years old;
  • have at least a 12-month history of T2DM based on the Canadian Diabetes Guidelines;
  • be community-dwelling;
  • live within 30km of their GP clinic in Abbotsford, BC (Canada);
  • able to comply with scheduled visits, treatment plan, and other trial procedures;
  • read, write, and speak English;
  • acceptable auditory acuity to participate in the Group Appointments and visual acuity to participate in the research;
  • provide a personally signed and dated informed consent;
  • able to walk independently;

You may not qualify if:

  • using insulin to treat diabetes to increase the homogeneity of the sample;
  • at high risk for cardiac complications during exercise and/or unable to self-regulate activity or to understand recommended activity level (i.e., Class C of the American Heart Risk Stratification Criteria);
  • Mini-Mental State Examination (MMSE)\[51\] score of ≤ 24 at screening;
  • have clinically significant peripheral neuropathy or severe musculoskeletal or joint disease that impairs mobility;
  • taking medications that may negatively affect the ability to undertake a simple walking program safely (e.g. beta blockers);
  • planning to participate, or already enrolled in, a clinical drug trial concurrent to this study.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Gateway Clinic / Kent Place Clinic

Abbotsford, British Columbia, V2S 3N5, Canada

RECRUITING

Centre for Hip Health and Mobility (Vancouver Coastal Health Research Institute/University of British Columbia)

Vancouver, British Columbia, V5Z 1M9, Canada

RECRUITING

Related Publications (74)

  • Public Health Agency of Canada. Diabetes in Canada: Facts and figures from a public health perspective 2011. Ottawa: Government of Canada, 2011.

    BACKGROUND

  • Lysy Z, Booth GL, Shah BR, Austin PC, Luo J, Lipscombe LL. The impact of income on the incidence of diabetes: a population-based study. Diabetes Res Clin Pract. 2013 Mar;99(3):372-9. doi: 10.1016/j.diabres.2012.12.005. Epub 2013 Jan 8.

    PMID: 23305902BACKGROUND

  • Dyck R, Karunanayake C, Pahwa P, Hagel L, Lawson J, Rennie D, Dosman J; Saskatchewan Rural Health Study Group. Prevalence, risk factors and co-morbidities of diabetes among adults in rural Saskatchewan: the influence of farm residence and agriculture-related exposures. BMC Public Health. 2013 Jan 5;13:7. doi: 10.1186/1471-2458-13-7.

    PMID: 23289729BACKGROUND

  • Cauch-Dudek K, Victor JC, Sigmond M, Shah BR. Disparities in attendance at diabetes self-management education programs after diagnosis in Ontario, Canada: a cohort study. BMC Public Health. 2013 Jan 30;13:85. doi: 10.1186/1471-2458-13-85.

    PMID: 23360373BACKGROUND

  • Meneilly GS. Diabetes in the elderly. Med Clin North Am. 2006 Sep;90(5):909-23. doi: 10.1016/j.mcna.2006.05.011.

    PMID: 16962849BACKGROUND

  • Doucet G, Beatty M. The cost of diabetes in Canada: the economic Tsunami. Can J Diabetes 2010;34:27-29

    BACKGROUND

  • Caro JJ, Getsios D, Caro I, Klittich WS, O'Brien JA. Economic evaluation of therapeutic interventions to prevent Type 2 diabetes in Canada. Diabet Med. 2004 Nov;21(11):1229-36. doi: 10.1111/j.1464-5491.2004.01330.x.

    PMID: 15498090BACKGROUND

  • Moffatt E, Shack LG, Petz GJ, Sauve JK, Hayward K, Colman R. The cost of obesity and overweight in 2005: a case study of Alberta, Canada. Can J Public Health. 2011 Mar-Apr;102(2):144-8. doi: 10.1007/BF03404164.

    PMID: 21608388BACKGROUND

  • Volpato S, Leveille SG, Blaum C, Fried LP, Guralnik JM. Risk factors for falls in older disabled women with diabetes: the women's health and aging study. J Gerontol A Biol Sci Med Sci. 2005 Dec;60(12):1539-45. doi: 10.1093/gerona/60.12.1539.

    PMID: 16424285BACKGROUND

  • Crane PK, Walker R, Larson EB. Glucose levels and risk of dementia. N Engl J Med. 2013 Nov 7;369(19):1863-4. doi: 10.1056/NEJMc1311765. No abstract available.

    PMID: 24195563BACKGROUND

  • Lam R, Gallinaro A, Adleman J. Medical Problems Referred to a Care of the Elderly Physician: Insight for Future Geriatrics CME. Can Geriatr J. 2013 Sep 4;16(3):114-9. doi: 10.5770/cgj.16.58. eCollection 2013.

    PMID: 23983827BACKGROUND

  • Hubbard RE, Andrew MK, Fallah N, Rockwood K. Comparison of the prognostic importance of diagnosed diabetes, co-morbidity and frailty in older people. Diabet Med. 2010 May;27(5):603-6. doi: 10.1111/j.1464-5491.2010.02977.x.

    PMID: 20536960BACKGROUND

  • Alexander GC, Sehgal NL, Moloney RM, Stafford RS. National trends in treatment of type 2 diabetes mellitus, 1994-2007. Arch Intern Med. 2008 Oct 27;168(19):2088-94. doi: 10.1001/archinte.168.19.2088.

    PMID: 18955637BACKGROUND

  • Furler J, Hii JW, Liew D, Blackberry I, Best J, Segal L, Young D. The "cost" of treating to target: cross-sectional analysis of patients with poorly controlled type 2 diabetes in Australian general practice. BMC Fam Pract. 2013 Mar 8;14:32. doi: 10.1186/1471-2296-14-32.

    PMID: 23510207BACKGROUND

  • Teoh H, Despres JP, Dufour R, Fitchett DH, Goldin L, Goodman SG, Harris SB, Langer A, Lau DC, Lonn EM, John Mancini GB, McFarlane PA, Poirier P, Rabasa-Lhoret R, Tan MK, Leiter LA. Identification and management of patients at elevated cardiometabolic risk in canadian primary care: how well are we doing? Can J Cardiol. 2013 Aug;29(8):960-8. doi: 10.1016/j.cjca.2012.12.001. Epub 2013 Mar 7.

    PMID: 23465284BACKGROUND

  • Umpierre D, Ribeiro PA, Schaan BD, Ribeiro JP. Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis. Diabetologia. 2013 Feb;56(2):242-51. doi: 10.1007/s00125-012-2774-z. Epub 2012 Nov 16.

    PMID: 23160642BACKGROUND

  • Ferchak CV, Meneghini LF. Obesity, bariatric surgery and type 2 diabetes--a systematic review. Diabetes Metab Res Rev. 2004 Nov-Dec;20(6):438-45. doi: 10.1002/dmrr.507.

    PMID: 15386803BACKGROUND

  • Staimez LR, Weber MB, Narayan KM, Oza-Frank R. A systematic review of overweight, obesity, and type 2 diabetes among Asian American subgroups. Curr Diabetes Rev. 2013 Jul;9(4):312-31. doi: 10.2174/15733998113099990061.

    PMID: 23590534BACKGROUND

  • Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403. doi: 10.1056/NEJMoa012512.

    PMID: 11832527BACKGROUND

  • Knowler WC. Prevention of type 2 diabetes: comment on "Lifestyle modification and prevention of type 2 diabetes in overweight Japanese with impaired fasting glucose levels". Arch Intern Med. 2011 Aug 8;171(15):1361-2. doi: 10.1001/archinternmed.2011.367. No abstract available.

    PMID: 21824949BACKGROUND

  • Buehler AM, Cavalcanti AB, Berwanger O, Figueiro M, Laranjeira LN, Zazula AD, Kioshi B, Bugano DG, Santucci E, Sbruzzi G, Guimaraes HP, Carvalho VO, Bordin SA. Effect of tight blood glucose control versus conventional control in patients with type 2 diabetes mellitus: a systematic review with meta-analysis of randomized controlled trials. Cardiovasc Ther. 2013 Jun;31(3):147-60. doi: 10.1111/j.1755-5922.2011.00308.x. Epub 2011 Dec 29.

    PMID: 22212499BACKGROUND

  • Al Sayah F, Williams B, Johnson JA. Measuring health literacy in individuals with diabetes: a systematic review and evaluation of available measures. Health Educ Behav. 2013 Feb;40(1):42-55. doi: 10.1177/1090198111436341. Epub 2012 Apr 9.

    PMID: 22491040BACKGROUND

  • Noffsinger E. Running Group Visits in Your Practice. NY, New York: Springer, 2009.

    BACKGROUND

  • Northern Health Authority. The Group Medical Appointment Manual First Edition 2007: Northern Health Authority 2007.

    BACKGROUND

  • EuroQol Group. EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990 Dec;16(3):199-208. doi: 10.1016/0168-8510(90)90421-9.

    PMID: 10109801BACKGROUND

  • Goossens ME, Rutten-van Molken MP, Vlaeyen JW, van der Linden SM. The cost diary: a method to measure direct and indirect costs in cost-effectiveness research. J Clin Epidemiol. 2000 Jul;53(7):688-95. doi: 10.1016/s0895-4356(99)00177-8.

    PMID: 10941945BACKGROUND

  • Canadian Diabetes Association Clinical Practice Guidelines Expert Committee; Booth G, Cheng AY. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Methods. Can J Diabetes. 2013 Apr;37 Suppl 1:S4-7. doi: 10.1016/j.jcjd.2013.01.010. Epub 2013 Mar 26. No abstract available.

    PMID: 24070961BACKGROUND

  • Manns B, Hemmelgarn B, Tonelli M, Au F, Chiasson TC, Dong J, Klarenbach S; Alberta Kidney Disease Network. Population based screening for chronic kidney disease: cost effectiveness study. BMJ. 2010 Nov 8;341:c5869. doi: 10.1136/bmj.c5869.

    PMID: 21059726BACKGROUND

  • Rein DB, Wittenborn JS, Zhang X, Allaire BA, Song MS, Klein R, Saaddine JB; Vision Cost-Effectiveness Study Group. The cost-effectiveness of three screening alternatives for people with diabetes with no or early diabetic retinopathy. Health Serv Res. 2011 Oct;46(5):1534-61. doi: 10.1111/j.1475-6773.2011.01263.x. Epub 2011 Apr 14.

    PMID: 21492158BACKGROUND

  • Steinsbekk A, Rygg LO, Lisulo M, Rise MB, Fretheim A. Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis. BMC Health Serv Res. 2012 Jul 23;12:213. doi: 10.1186/1472-6963-12-213.

    PMID: 22824531BACKGROUND

  • Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-management of chronic disease in primary care. JAMA. 2002 Nov 20;288(19):2469-75. doi: 10.1001/jama.288.19.2469.

    PMID: 12435261BACKGROUND

  • Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA. 2002 Oct 16;288(15):1909-14. doi: 10.1001/jama.288.15.1909.

    PMID: 12377092BACKGROUND

  • Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA. 2002 Oct 9;288(14):1775-9. doi: 10.1001/jama.288.14.1775.

    PMID: 12365965BACKGROUND

  • Trento M, Passera P, Tomalino M, Bajardi M, Pomero F, Allione A, Vaccari P, Molinatti GM, Porta M. Group visits improve metabolic control in type 2 diabetes: a 2-year follow-up. Diabetes Care. 2001 Jun;24(6):995-1000. doi: 10.2337/diacare.24.6.995.

    PMID: 11375359BACKGROUND

  • Trento M, Gamba S, Gentile L, Grassi G, Miselli V, Morone G, Passera P, Tonutti L, Tomalino M, Bondonio P, Cavallo F, Porta M; ROMEO Investigators. Rethink Organization to iMprove Education and Outcomes (ROMEO): a multicenter randomized trial of lifestyle intervention by group care to manage type 2 diabetes. Diabetes Care. 2010 Apr;33(4):745-7. doi: 10.2337/dc09-2024. Epub 2010 Jan 26.

    PMID: 20103547BACKGROUND

  • Housden L, Wong ST, Dawes M. Effectiveness of group medical visits for improving diabetes care: a systematic review and meta-analysis. CMAJ. 2013 Sep 17;185(13):E635-44. doi: 10.1503/cmaj.130053. Epub 2013 Aug 12.

    PMID: 23939218BACKGROUND

  • Edelman D, Fredrickson SK, Melnyk SD, Coffman CJ, Jeffreys AS, Datta S, Jackson GL, Harris AC, Hamilton NS, Stewart H, Stein J, Weinberger M. Medical clinics versus usual care for patients with both diabetes and hypertension: a randomized trial. Ann Intern Med. 2010 Jun 1;152(11):689-96. doi: 10.7326/0003-4819-152-11-201006010-00001.

    PMID: 20513826BACKGROUND

  • Lavoie JG, Wong ST, Chongo M, Browne AJ, MacLeod ML, Ulrich C. Group medical visits can deliver on patient-centred care objectives: results from a qualitative study. BMC Health Serv Res. 2013 Apr 29;13:155. doi: 10.1186/1472-6963-13-155.

    PMID: 23627609BACKGROUND

  • MacCarthy D, Kallstrom L, Kadlec H, Hollander M. Improving primary care in British Columbia, Canada: evaluation of a peer-to-peer continuing education program for family physicians. BMC Med Educ. 2012 Nov 9;12:110. doi: 10.1186/1472-6920-12-110.

    PMID: 23140230BACKGROUND

  • Pradhan AD, Rifai N, Buring JE, Ridker PM. Hemoglobin A1c predicts diabetes but not cardiovascular disease in nondiabetic women. Am J Med. 2007 Aug;120(8):720-7. doi: 10.1016/j.amjmed.2007.03.022.

    PMID: 17679132BACKGROUND

  • Khaw KT, Wareham N, Bingham S, Luben R, Welch A, Day N. Association of hemoglobin A1c with cardiovascular disease and mortality in adults: the European prospective investigation into cancer in Norfolk. Ann Intern Med. 2004 Sep 21;141(6):413-20. doi: 10.7326/0003-4819-141-6-200409210-00006.

    PMID: 15381514BACKGROUND

  • Kodama S, Horikawa C, Fujihara K, Hirasawa R, Yachi Y, Yoshizawa S, Tanaka S, Sone Y, Shimano H, Iida KT, Saito K, Sone H. Use of high-normal levels of haemoglobin A(1C) and fasting plasma glucose for diabetes screening and for prediction: a meta-analysis. Diabetes Metab Res Rev. 2013 Nov;29(8):680-92. doi: 10.1002/dmrr.2445.

    PMID: 23963843BACKGROUND

  • Bonora E, Tuomilehto J. The pros and cons of diagnosing diabetes with A1C. Diabetes Care. 2011 May;34 Suppl 2(Suppl 2):S184-90. doi: 10.2337/dc11-s216. No abstract available.

    PMID: 21525453BACKGROUND

  • Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Applied Psychology 2008;57(1):1-29

    BACKGROUND

  • Petrella RJ, Aizawa K, Shoemaker K, Overend T, Piche L, Marin M, Shapiro S, Atkin S. Efficacy of a family practice-based lifestyle intervention program to increase physical activity and reduce clinical and physiological markers of vascular health in patients with high normal blood pressure and/or high normal blood glucose (SNAC): study protocol for a randomized controlled trial. Trials. 2011 Feb 16;12:45. doi: 10.1186/1745-6215-12-45.

    PMID: 21324150BACKGROUND

  • Petrella RJ, Lattanzio CN. Does counseling help patients get active? Systematic review of the literature. Can Fam Physician. 2002 Jan;48:72-80.

    PMID: 11852615BACKGROUND

  • Petrella RJ, Lattanzio CN, Overend TJ. Physical activity counseling and prescription among canadian primary care physicians. Arch Intern Med. 2007 Sep 10;167(16):1774-81. doi: 10.1001/archinte.167.16.1774.

    PMID: 17846397BACKGROUND

  • Williford HN, Barfield BR, Lazenby RB, Olson MS. A survey of physicians' attitudes and practices related to exercise promotion. Prev Med. 1992 Sep;21(5):630-6. doi: 10.1016/0091-7435(92)90070-x.

    PMID: 1438111BACKGROUND

  • Liu-Ambrose TY, Khan KM, Eng JJ, Gillies GL, Lord SR, McKay HA. The beneficial effects of group-based exercises on fall risk profile and physical activity persist 1 year postintervention in older women with low bone mass: follow-up after withdrawal of exercise. J Am Geriatr Soc. 2005 Oct;53(10):1767-73. doi: 10.1111/j.1532-5415.2005.53525.x.

    PMID: 16181178BACKGROUND

  • Davis JC, Marra CA, Beattie BL, Robertson MC, Najafzadeh M, Graf P, Nagamatsu LS, Liu-Ambrose T. Sustained cognitive and economic benefits of resistance training among community-dwelling senior women: a 1-year follow-up study of the Brain Power study. Arch Intern Med. 2010 Dec 13;170(22):2036-8. doi: 10.1001/archinternmed.2010.462. No abstract available.

    PMID: 21149764BACKGROUND

  • Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189-98. doi: 10.1016/0022-3956(75)90026-6. No abstract available.

    PMID: 1202204BACKGROUND

  • Reliability and validity of a diabetes quality-of-life measure for the diabetes control and complications trial (DCCT). The DCCT Research Group. Diabetes Care. 1988 Oct;11(9):725-32. doi: 10.2337/diacare.11.9.725.

    PMID: 3066604BACKGROUND

  • Dolan P, Roberts J. Modelling valuations for Eq-5d health states: an alternative model using differences in valuations. Med Care. 2002 May;40(5):442-6. doi: 10.1097/00005650-200205000-00009.

    PMID: 11961478BACKGROUND

  • Davis JC, Liu-Ambrose T, Khan KM, Robertson MC, Marra CA. SF-6D and EQ-5D result in widely divergent incremental cost-effectiveness ratios in a clinical trial of older women: implications for health policy decisions. Osteoporos Int. 2012 Jul;23(7):1849-57. doi: 10.1007/s00198-011-1770-3. Epub 2011 Sep 10.

    PMID: 21909728BACKGROUND

  • Davis JC, Marra CA, Robertson MC, Khan KM, Najafzadeh M, Ashe MC, Liu-Ambrose T. Economic evaluation of dose-response resistance training in older women: a cost-effectiveness and cost-utility analysis. Osteoporos Int. 2011 May;22(5):1355-66. doi: 10.1007/s00198-010-1356-5. Epub 2010 Aug 4.

    PMID: 20683707BACKGROUND

  • Koopman JJ, van Bodegom D, Jukema JW, Westendorp RG. Risk of cardiovascular disease in a traditional African population with a high infectious load: a population-based study. PLoS One. 2012;7(10):e46855. doi: 10.1371/journal.pone.0046855. Epub 2012 Oct 11.

    PMID: 23071653BACKGROUND

  • Hologic Inc. Hologic QDR User's Guide. Bedford, MA: Hologic Inc

    BACKGROUND

  • Anderson TJ, Gregoire J, Hegele RA, Couture P, Mancini GB, McPherson R, Francis GA, Poirier P, Lau DC, Grover S, Genest J Jr, Carpentier AC, Dufour R, Gupta M, Ward R, Leiter LA, Lonn E, Ng DS, Pearson GJ, Yates GM, Stone JA, Ur E. 2012 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2013 Feb;29(2):151-67. doi: 10.1016/j.cjca.2012.11.032.

    PMID: 23351925BACKGROUND

  • Canadian Diabetes Association Clinical Practice Guidelines Expert Committee; Cheng AY. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Introduction. Can J Diabetes. 2013 Apr;37 Suppl 1:S1-3. doi: 10.1016/j.jcjd.2013.01.009. Epub 2013 Mar 26. No abstract available.

    PMID: 24070926BACKGROUND

  • Washburn RA, McAuley E, Katula J, Mihalko SL, Boileau RA. The physical activity scale for the elderly (PASE): evidence for validity. J Clin Epidemiol. 1999 Jul;52(7):643-51. doi: 10.1016/s0895-4356(99)00049-9.

    PMID: 10391658BACKGROUND

  • Hoppmann CA, Coats AH, Blanchard-Fields F. Goals and everyday problem solving: examining the link between age-related goals and problem-solving strategy use. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2008 Jul;15(4):401-23. doi: 10.1080/13825580701533777.

    PMID: 17899456BACKGROUND

  • Slade L, C. H. Time-sampling research in Health Psychology: Potential contributions and new trends. European Health Psychologist 2011;13:65-9

    BACKGROUND

  • Hoppmann C, Gerstorf D. Spousal goals, affect quality, and collaborative problem solving: Evidence from a time-sampling study with older couples. Research in Human Development 2013;10:70-87

    BACKGROUND

  • Drummond MF, Sculpher MJ, Torrance GW, et al. Methods for the Economic Evaluation of Health Care Programmes (Third Edition). New York: Oxford University Press 2005.

    BACKGROUND

  • Davis JC, Robertson MC, Ashe MC, Liu-Ambrose T, Khan KM, Marra CA. Does a home-based strength and balance programme in people aged > or =80 years provide the best value for money to prevent falls? A systematic review of economic evaluations of falls prevention interventions. Br J Sports Med. 2010 Feb;44(2):80-9. doi: 10.1136/bjsm.2008.060988.

    PMID: 20154094BACKGROUND

  • Davis JC, Robertson MC, Ashe MC, Liu-Ambrose T, Khan KM, Marra CA. International comparison of cost of falls in older adults living in the community: a systematic review. Osteoporos Int. 2010 Aug;21(8):1295-306. doi: 10.1007/s00198-009-1162-0. Epub 2010 Feb 27.

    PMID: 20195846BACKGROUND

  • Marra CA, Cibere J, Grubisic M, Grindrod KA, Gastonguay L, Thomas JM, Embley P, Colley L, Tsuyuki RT, Khan KM, Esdaile JM. Pharmacist-initiated intervention trial in osteoarthritis: a multidisciplinary intervention for knee osteoarthritis. Arthritis Care Res (Hoboken). 2012 Dec;64(12):1837-45. doi: 10.1002/acr.21763.

    PMID: 22930542BACKGROUND

  • Woolcott JC, Khan KM, Mitrovic S, Anis AH, Marra CA. The cost of fall related presentations to the ED: a prospective, in-person, patient-tracking analysis of health resource utilization. Osteoporos Int. 2012 May;23(5):1513-9. doi: 10.1007/s00198-011-1764-1. Epub 2011 Sep 3.

    PMID: 21892675BACKGROUND

  • Woolcott JC, Richardson KJ, Wiens MO, Patel B, Marin J, Khan KM, Marra CA. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009 Nov 23;169(21):1952-60. doi: 10.1001/archinternmed.2009.357.

    PMID: 19933955BACKGROUND

  • Guimaraes C, Marra CA, Colley L, Gill S, Simpson S, Meneilly G, Queiroz RH, Lynd LD. Socioeconomic differences in preferences and willingness-to-pay for insulin delivery systems in type 1 and type 2 diabetes. Diabetes Technol Ther. 2009 Sep;11(9):567-73. doi: 10.1089/dia.2009.0034.

    PMID: 19764835BACKGROUND

  • Guimaraes C, Marra CA, Colley L, Gill S, Simpson SH, Meneilly GS, Queiroz RH, Lynd LD. A valuation of patients' willingness-to-pay for insulin delivery in diabetes. Int J Technol Assess Health Care. 2009 Jul;25(3):359-66. doi: 10.1017/S0266462309990055.

    PMID: 19619355BACKGROUND

  • Kroenke K, Spitzer RL, Williams JB, Monahan PO, Lowe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007 Mar 6;146(5):317-25. doi: 10.7326/0003-4819-146-5-200703060-00004.

    PMID: 17339617BACKGROUND

  • Sims Gould J, Tong C, Ly J, Vazirian S, Windt A, Khan K. Process evaluation of team-based care in people aged >65 years with type 2 diabetes mellitus. BMJ Open. 2019 Aug 2;9(8):e029965. doi: 10.1136/bmjopen-2019-029965.

    PMID: 31377711DERIVED

  • Khan KM, Windt A, Davis JC, Dawes M, Liu-Ambrose T, Madden K, Marra CA, Housden L, Hoppmann C, Adams DJ. Group Medical Visits (GMVs) in primary care: an RCT of group-based versus individual appointments to reduce HbA1c in older people. BMJ Open. 2015 Jul 13;5(7):e007441. doi: 10.1136/bmjopen-2014-007441.

    PMID: 26169803DERIVED

MeSH Terms

Conditions

Diabetes Mellitus, Type 2Diabetes MellitusMotor ActivityPatient Acceptance of Health CareDepressionAnxiety Disorders

Interventions

Shared Medical Appointments

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesBehaviorTreatment Adherence and ComplianceHealth BehaviorBehavioral SymptomsMental Disorders

Intervention Hierarchy (Ancestors)

Patient CareTherapeuticsAppointments and SchedulesOrganization and AdministrationHealth Services AdministrationPractice Management, MedicalPractice ManagementProfessional Practice

Study Officials

  • Karim Miran-Khan, MD, PhD, MBA

    Centre for Hip Health and Mobility (University of British Columbia)

    PRINCIPAL INVESTIGATOR

  • Jennifer Davis, PhD

    UBC Department of Population & Public Health

    STUDY DIRECTOR

  • Martin Dawes, MB.BS, MD

    UBC Department of Family Practice

    STUDY DIRECTOR

  • Christiane Hoppmann, PhD

    UBC Psychology Department

    STUDY DIRECTOR

  • Teresa Liu-Ambrose, PhD, PT

    UBC Department of Physical Therapy

    STUDY DIRECTOR

  • Ken Madden, MD

    UBC Department of Medicine (Geriatric Medicine)

    STUDY DIRECTOR

  • Carlo Marra, Pharm.D, PhD

    UBC Faculty of Pharmaceutical Sciences

    STUDY DIRECTOR

  • Adriaan Windt, MD

    UBC Department of Family Practice

    STUDY DIRECTOR

  • Laura Housden, MN-NP(F)

    UBC School of Nursing

    STUDY DIRECTOR

Central Study Contacts

Adriaan Windt, MD

CONTACT

604-859-9084adriaan.windt@gmail.com

Jessica Ly, BA, MA

CONTACT

778-998-0851Jessica.Ly@familymed.ubc.ca

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

November 28, 2013

First Posted

December 5, 2013

Study Start

January 1, 2014

Primary Completion

February 1, 2019

Study Completion

February 1, 2020

Last Updated

November 22, 2017

Record last verified: 2017-11

Locations

CA(2)