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| Name | Class |
|---|---|
| Pfizer | INDUSTRY |
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The primary objective of this study is to identify whether cardiovascular complication rates are lower in patients who participate in managed diabetes care, in comparison to provincial and national rates. This study will involve an electronic medical record (EMR) chart audit, augmented by a manual review of hospital and other pertinent medical records, as necessary.
The DECIDE study will identify whether cardiovascular complication rates (the composite rate of myocardial infarction (MI), Percutaneous Coronary Intervention (PCI), Coronary Artery Bypass Grafting (CABG), stroke, carotid endarterectomy, peripheral revascularization, and peripheral amputation) are lower in patients who participate in managed diabetes care by ADEC in comparison to provincial and national rates. Comparison statistics will be provided by the Institute of Evaluative Sciences (ICES) Atlas 2003 and other Diabetes studies such as the 2005 DICE study. Complications such as nephropathy and retinopathy will be documented, along with hospitalization rates and all cause mortality. Clinical outcomes relevant to diabetes management such as blood pressure and lipids will also be compared.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ADEC <6months | Patients new to the ADEC program who will be provided the ADEC interventions (prospective study) |
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| ADEC >6months | Patients who have been with the ADEC program as early as 2002 (coincides with ADEC's EMR initiation date) who continue to be provided the ADEC interventions (combined retrospective/prospective study) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ADEC Program | Other | Interventions (managed diabetes care) employed by the ADEC Program include: diabetes education, nutrition care, individual and group counseling sessions, foot care, and insulin and oral diabetes medication adjustments with a signed medical directive. ADEC Diabetes Educators (Registered Dietitians and Registered Nurses) will use adult education principles throughout the education process and promote self-care by encouraging responsibility and promoting a positive attitude towards acceptance of diabetes. All patients will be encouraged to self-monitor their blood glucose at home. Team member collaboration and with other agencies to promote a total client care approach to diabetes management will be employed. |
| Measure | Description | Time Frame |
|---|---|---|
| Rates of cardiovascular events and other complications of diabetes compared to provincial and national rates | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| The secondary outcomes will be total mortality, CV- related events, and other selected complications of diabetes. | 1 year |
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Inclusion Criteria:
Exclusion Criteria:
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Ambulatory patients of the Group Health Centre who are over the age of 18 years with a confirmed diagnosis of diabetes mellitus and who are enrolled in the Algoma Diabetes Education and Care (ADEC) program. ADEC is a managed diabetes care program and part of the Group Health Centre (GHC), a multi-specialty, interdisciplinary, ambulatory care facility located in Sault Ste. Marie, a northern Ontario community. With diagnostic services and a comprehensive electronic medical record, GHC provides health care to most of the community's population of approximately 75,000.
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| Name | Affiliation | Role |
|---|---|---|
| Silvana Spadafora, MD FRCPC | The Group Health Centre | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Group Health Centre | Sault Ste. Marie | Ontario | P6A 1Y7 | Canada |
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| Label | URL |
|---|---|
| Group Health Centre website | View source |
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|
| ID | Term |
|---|---|
| D048909 | Diabetes Complications |
| D003925 | Diabetic Angiopathies |
| D003929 | Diabetic Neuropathies |
| D003928 | Diabetic Nephropathies |
| D003930 | Diabetic Retinopathy |
| D000787 | Angina Pectoris |
| D003324 | Coronary Artery Disease |
| D020521 | Stroke |
| D009203 | Myocardial Infarction |
| D006333 | Heart Failure |
| D007238 | Infarction |
| D007674 | Kidney Diseases |
| D051437 | Renal Insufficiency |
| D016491 | Peripheral Vascular Diseases |
| D012164 | Retinal Diseases |
| D003251 | Constriction, Pathologic |
| D014456 | Ulcer |
| D014652 | Vascular Diseases |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
| D002318 | Cardiovascular Diseases |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D005128 | Eye Diseases |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002637 | Chest Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D003327 | Coronary Disease |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D009336 | Necrosis |
| D020763 | Pathological Conditions, Anatomical |
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