The Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) protocol: a non-randomised controlled trial of personalised care and support planning for persons living with diabetes.
Care and support planning
Diabetes mellitus.
Long term conditions.
Patient activation.
Primary care.
Self-management.
Journal
BMC family practice
ISSN: 1471-2296
Titre abrégé: BMC Fam Pract
Pays: England
ID NLM: 100967792
Informations de publication
Date de publication:
19 06 2020
19 06 2020
Historique:
received:
24
04
2020
accepted:
25
05
2020
entrez:
21
6
2020
pubmed:
21
6
2020
medline:
10
7
2021
Statut:
epublish
Résumé
Personalised care and support planning (CSP) has been shown to improve diabetes outcomes, patient experience and provider morale in the care of persons living with diabetes. However, this has not been confirmed in controlled studies. Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) is a pragmatic controlled trial that evaluates the effectiveness of personalised CSP in persons living with diabetes in the public primary care setting in Singapore. Teamlet-empanelled patients with diabetes at four polyclinics are recruited for this study. Participants who attend either of the two Intervention clinics are sent their investigation results in a care planning letter (CPL) to prepare them for the CSP conversation. This conversation is facilitated by a trained CSP practitioner who engages them in discussion of concerns, goals and action plans, and documents their plans for subsequent review. Participants in the two Control clinics will receive standard diabetes care. Participants will complete two or more CSP conversations (Intervention) or regular consultations (Control) at the annual review visits within the 18 months of the study. The sample size is calculated at 1620 participants, with glycated haemoglobin (HbA1c) as the primary outcome measure. Secondary outcome measures include patient activation (as measured by PAM-13) and changes in healthcare utilisation and cost. This study is a pragmatic trial that evaluates the effectiveness of personalised CSP in persons living with diabetes in a real world setting. It promises to provide insights with regard to the implementation of this model of care in Singapore and the region. ClinicalTrials.gov Identifier NCT04288362. Retrospectively registered on 28 February 2020.
Sections du résumé
BACKGROUND
Personalised care and support planning (CSP) has been shown to improve diabetes outcomes, patient experience and provider morale in the care of persons living with diabetes. However, this has not been confirmed in controlled studies. Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) is a pragmatic controlled trial that evaluates the effectiveness of personalised CSP in persons living with diabetes in the public primary care setting in Singapore.
METHODS
Teamlet-empanelled patients with diabetes at four polyclinics are recruited for this study. Participants who attend either of the two Intervention clinics are sent their investigation results in a care planning letter (CPL) to prepare them for the CSP conversation. This conversation is facilitated by a trained CSP practitioner who engages them in discussion of concerns, goals and action plans, and documents their plans for subsequent review. Participants in the two Control clinics will receive standard diabetes care. Participants will complete two or more CSP conversations (Intervention) or regular consultations (Control) at the annual review visits within the 18 months of the study. The sample size is calculated at 1620 participants, with glycated haemoglobin (HbA1c) as the primary outcome measure. Secondary outcome measures include patient activation (as measured by PAM-13) and changes in healthcare utilisation and cost.
DISCUSSION
This study is a pragmatic trial that evaluates the effectiveness of personalised CSP in persons living with diabetes in a real world setting. It promises to provide insights with regard to the implementation of this model of care in Singapore and the region.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier NCT04288362. Retrospectively registered on 28 February 2020.
Identifiants
pubmed: 32560689
doi: 10.1186/s12875-020-01173-2
pii: 10.1186/s12875-020-01173-2
pmc: PMC7305581
doi:
Banques de données
ClinicalTrials.gov
['NCT04288362']
Types de publication
Clinical Trial Protocol
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
114Subventions
Organisme : Singapore Ministry of Health
ID : MH34:31/2
Pays : International
Références
J Am Board Fam Med. 2016 Jan-Feb;29(1):135-8
pubmed: 26769885
J Diabetes Res. 2016;2016:7386532
pubmed: 27656658
Health Serv Res. 2004 Aug;39(4 Pt 1):1005-26
pubmed: 15230939
Milbank Q. 1996;74(4):511-44
pubmed: 8941260
Qual Health Res. 2018 Dec;28(14):2250-2266
pubmed: 29676217
J Am Board Fam Med. 2012 Mar-Apr;25(2):245-6
pubmed: 22403207
Diabetes Care. 2016 Mar;39(3):472-85
pubmed: 26908931
BMC Fam Pract. 2019 Nov 8;20(1):153
pubmed: 31703620
Br J Gen Pract. 2006 Jun;56(527):407-14
pubmed: 16762121
BMC Fam Pract. 2018 Jan 9;19(1):11
pubmed: 29316889
Cochrane Database Syst Rev. 2015 Mar 03;(3):CD010523
pubmed: 25733495
Nephrol Dial Transplant. 2015 Aug;30(8):1244-9
pubmed: 25813274
BMC Health Serv Res. 2014 Sep 16;14:393
pubmed: 25227734
Can Fam Physician. 2014 Apr;60(4):e230-6
pubmed: 24733343
BMJ. 2015 Nov 04;351:h5651
pubmed: 26537915
Psychol Rev. 1977 Mar;84(2):191-215
pubmed: 847061
Diabetes Care. 2002 Jul;25(7):1159-71
pubmed: 12087014
Br J Gen Pract. 2010 May;60(574):e201-12
pubmed: 20423575
BMC Public Health. 2016 Feb 16;16:153
pubmed: 26880337
BMC Fam Pract. 2012 Jul 25;13:71
pubmed: 22831570