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综合护理方案对初诊 2 型糖尿病及相关合并症患者的疗效:一项准实验研究的研究方案。

Effectiveness of a comprehensive care protocol in patients with new diagnoses of type 2 diabetes mellitus and associated comorbidities in primary care: study protocol of a quasi-experimental trial.

机构信息

Centre d'Atenció Primària Sanllehy, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Barcelona, Spain

Unitat de Suport a la Recerca Barcelona Ciutat, Fundació Institut Universitari per a la recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP Jordi Gol), Barcelona, Spain.

出版信息

BMJ Open. 2020 Jun 23;10(6):e033725. doi: 10.1136/bmjopen-2019-033725.

Abstract

INTRODUCTION

Type 2 diabetes mellitus (T2DM) is a highly prevalent chronic disease in the Spanish population. Typically, T2DM is associated with other chronic conditions. Intensive medication at the time of diagnosis has proven effective in reducing cardiovascular risk, improving glycaemic control and preventing T2DM complications. However, it has not yet been demonstrated that a comprehensive and intensive health education protocol at the time of diagnosis has the benefits described previously. Currently, there is great variability in the practices of primary care nurses regarding health education at the time of disease diagnosis.We aimed to evaluate the effectiveness of a systematic protocol with a comprehensive care programme in people with newly diagnosed T2DM with associated comorbidities.

METHODS AND ANALYSIS

A multicentre quasi-experimental design comparing a group of individuals taking part in the intervention (intervention group (IG)) with a similar group receiving standard diabetes care (comparison group (CG)) is planned. The intervention will take place during the 3 months after study enrolment. Data will be collected at baseline and at 3, 6 and 12 months. Ten primary care centres in Barcelona city will be selected for participation: 5 for the IG and 5 for the CG. The IG will include five structured individual visits postdiagnosis with the primary care nurse, during which aspects of diabetes education will be discussed with the patient and his/her family. The results will be measured in terms of health-related quality of life and the change in main outcomes (glycated haemoglobin and weight).

ETHICS AND DISSEMINATION

The study fully met the requirements of the Ethical Committee of Clinical Investigation of the IDIAP Jordi Gol (approval code: P13/118). Patients will be informed that their data are confidential, and they have the right to withdraw at any time without penalty. Dissemination will include publishing the findings in peer-reviewed journals and sharing our findings at scientific conferences.

TRIAL REGISTRATION NUMBER

NCT03990857; Pre-results.

摘要

简介

2 型糖尿病(T2DM)是西班牙人群中一种高发的慢性疾病。通常,T2DM 与其他慢性疾病有关。在诊断时进行强化药物治疗已被证明可有效降低心血管风险、改善血糖控制并预防 T2DM 并发症。然而,目前尚未证明在诊断时实施全面强化健康教育方案具有上述益处。目前,初级保健护士在疾病诊断时进行健康教育的实践存在很大差异。我们旨在评估一种新诊断的 T2DM 伴相关合并症患者使用系统方案和综合护理方案的效果。

方法和分析

计划采用多中心准实验设计比较参与干预的一组个体(干预组(IG))和接受标准糖尿病护理的类似组(对照组(CG))。干预将在研究入组后 3 个月内进行。数据将在基线和 3、6 和 12 个月时收集。将选择巴塞罗那市的 10 个初级保健中心参与:5 个用于 IG,5 个用于 CG。IG 将包括诊断后与初级保健护士进行的五次结构化个体访视,在此期间将与患者及其家属讨论糖尿病教育的各个方面。结果将根据健康相关生活质量和主要结局(糖化血红蛋白和体重)的变化来衡量。

伦理和传播

该研究完全符合 IDIAP Jordi Gol 临床研究伦理委员会的要求(批准文号:P13/118)。将告知患者其数据是保密的,并且他们有权随时撤回而不受处罚。传播将包括在同行评审期刊上发表研究结果,并在科学会议上分享我们的研究结果。

试验注册号

NCT03990857;预结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c870/7312326/d1ca66accaa6/bmjopen-2019-033725f01.jpg

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