Primary Care Research Unit of Bizkaia, Basque Healthcare Service, Osakidetza, BioCruces Health Research Institute, Luis Power 18, E48014, Bilbao, Spain.
Osakidetza, Unidad de Investigación de Atención Primaria, Luis Power 18, 4ª planta, E-48014, Bilbao, Spain.
Implement Sci. 2018 Jul 11;13(1):94. doi: 10.1186/s13012-018-0783-0.
There is a lack of evidence concerning the effectiveness of different strategies to engage healthcare professionals in collaborative processes that seek to optimise clinical practice. The PREDIAPS project aims to assess the effect of different primary health care (PHC) providers' engagement procedures in the creation and execution of a facilitated interprofessional collaborative process to optimise the integration of the recommended clinical practice for the prevention of type-2 diabetes (T2D) in routine PHC.
This will be a randomised cluster type II hybrid implementation trial. Nine PHC centres from the Basque Health Service (Osakidetza) will be allocated to two different procedures to engage family doctors and nurses and create an interprofessional collaborative practice to optimise the integration of a T2D primary prevention programme. All centres and PHC professionals will receive training on current guidelines in primary prevention of T2D and effective interventions to promote healthy lifestyles. Headed by a local leader and an external facilitator, centres will conduct a collaborative structured process to model and adapt the intervention and its implementation to the specific context of professionals and centres. One of the groups will apply this strategy globally, promoting the cooperation of all health professionals from the beginning. The other will perform it sequentially, centred first on nurses, who will then seek the pragmatic cooperation of doctors. All patients without diabetes aged ≥ 30 years old who attend collaborating centres at least once during the study period and found to be at high risk of developing T2D will be eligible for programme inclusion. The main outcome measures focus on changes observed in indicators of T2D prevention clinical practice at centre level after 12 and 24 months, associated with the application of one or other engagement procedure. Secondary outcomes will compare their clinical effectiveness in changing eligible exposed patients' main lifestyle behaviours and risk factors (physical activity and diet, weight, etc.) after 12 months.
The PREDIAPS project will generate scientific knowledge on procedures for engaging PHC professional to facilitate feasible and effective adoption of proven interventions for the prevention of T2D in routine clinical practice through the application of implementation strategies.
Clinicaltrials.gov identifier: NCT03254979 . Registered 16 August 2017.
在促进医疗保健专业人员参与旨在优化临床实践的协作过程的不同策略的有效性方面，证据不足。PREDIAPS 项目旨在评估不同的初级保健（PHC）提供者参与程序对创建和执行促进专业间协作过程的影响，以优化推荐的预防 2 型糖尿病（T2D）的临床实践在常规 PHC 中的整合。
这将是一项随机对照二级混合实施试验。来自巴斯克卫生服务（Osakidetza）的 9 个 PHC 中心将被分配到两种不同的程序，以吸引家庭医生和护士，并创建一个跨专业的协作实践，以优化 T2D 初级预防计划的整合。所有中心和 PHC 专业人员将接受有关 T2D 初级预防和促进健康生活方式的有效干预措施的当前指南的培训。在当地领导人和外部协调员的领导下，中心将开展协作的结构化流程，对干预措施及其实施进行建模和调整，以适应专业人员和中心的具体情况。一组将在全球范围内应用这一策略，从一开始就促进所有卫生专业人员的合作。另一组将按顺序进行，首先集中在护士身上，然后寻求医生的务实合作。所有在研究期间至少一次到合作中心就诊且被认为有患 T2D 高风险的≥30 岁无糖尿病患者将有资格参加该计划。主要观察指标是在应用一种或另一种参与程序后，中心层面预防 T2D 的临床实践指标在 12 个月和 24 个月时观察到的变化。次要结果将比较它们在改变合格暴露患者的主要生活方式行为和风险因素（体力活动和饮食、体重等）方面的临床效果在 12 个月后。
PREDIAPS 项目将生成有关参与 PHC 专业人员的程序的科学知识，以通过应用实施策略，促进已证实的预防 T2D 干预措施在常规临床实践中的可行和有效采用。
Clinicaltrials.gov 标识符：NCT03254979。注册于 2017 年 8 月 16 日。
