Skip to main content
Top
Published in: BMC Primary Care 1/2014

Open Access 01-12-2014 | Study protocol

Nurse-led telecoaching of people with type 2 diabetes in primary care: rationale, design and baseline data of a randomized controlled trial

Authors: Irina Odnoletkova, Geert Goderis, Frank Nobels, Bert Aertgeerts, Lieven Annemans, Dirk Ramaekers

Published in: BMC Primary Care | Issue 1/2014

Login to get access

Abstract

Background

Despite the efforts of the healthcare community to improve the quality of diabetes care, about 50% of people with type 2 diabetes do not reach their treatment targets, increasing the risk of future micro-and macro-vascular complications. Diabetes self-management education has been shown to contribute to better disease control. However, it is not known which strategies involving educational programs are cost-effective. Telehealth applications might support chronic disease management. Transferability of successful distant patient self-management support programs to the Belgian setting needs to be confirmed by studies of a high methodological quality. “The COACH Program” was developed in Australia as target driven educational telephone delivered intervention to support people with different chronic conditions. It proved to be effective in patients with coronary heart disease after hospitalization. Clinical and cost-effectiveness of The COACH Program in people with type 2 diabetes in Belgium needs to be assessed.

Methods/Design

Randomized controlled trial in patients with type 2 diabetes. Patients were selected based on their medication consumption data and were recruited by their sickness fund. They were randomized to receive either usual care plus “The COACH Program” or usual care alone. The study will assess the difference in outcomes between groups. The primary outcome measure is the level of HbA1c. The secondary outcomes are: Total Cholesterol, LDL-Cholesterol, HDL-Cholesterol, Triglycerides, Blood Pressure, body mass index, smoking status; proportion of people at target for HbA1c, LDL-Cholesterol and Blood Pressure; self-perceived health status, diabetes-specific emotional distress and satisfaction with diabetes care. The follow-up period is 18 months. Within-trial and modeled cost-utility analyses, to project effects over life-time horizon beyond the trial duration, will be undertaken from the perspective of the health care system if the intervention is effective.

Discussion

The study will enhance our understanding of the potential of telehealth in diabetes management in Belgium. Research on the clinical effectiveness and the cost-effectiveness is essential to support policy makers in future reimbursement and implementation decisions.

Trial registration

Belgian number: B322201213625. ClinicalTrials.gov Identifier: NCT01612520
Appendix
Available only for authorised users
Literature
2.
go back to reference Goderis G, Borgermans L, Heyrman J, Broeke CV, Grol R, Boland B, Mathieu C: Type 2 diabetes in primary care in belgium: need for structured shared care. Exp Clin Endocrinol Diab. 2009, 117 (8): 367-372. 10.1055/s-0028-1103286.CrossRef Goderis G, Borgermans L, Heyrman J, Broeke CV, Grol R, Boland B, Mathieu C: Type 2 diabetes in primary care in belgium: need for structured shared care. Exp Clin Endocrinol Diab. 2009, 117 (8): 367-372. 10.1055/s-0028-1103286.CrossRef
3.
go back to reference Tricco AC, Ivers NM, Grimshaw JM, Mohler , Turner L, Galipeau J, Halperin I, Vachon B, Ramsay T, Manns B, Tonelli M, Shojania K: Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis. Lancet. 2012, 379: 2252-2261. 10.1016/S0140-6736(12)60480-2.CrossRefPubMed Tricco AC, Ivers NM, Grimshaw JM, Mohler , Turner L, Galipeau J, Halperin I, Vachon B, Ramsay T, Manns B, Tonelli M, Shojania K: Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis. Lancet. 2012, 379: 2252-2261. 10.1016/S0140-6736(12)60480-2.CrossRefPubMed
4.
go back to reference Norris SL, Lau J, Smith SJ, Schmid CH, Engelgau MM: Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glyceamic control. Diabetes Care. 2002, 25: 1159-1171. 10.2337/diacare.25.7.1159.CrossRefPubMed Norris SL, Lau J, Smith SJ, Schmid CH, Engelgau MM: Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glyceamic control. Diabetes Care. 2002, 25: 1159-1171. 10.2337/diacare.25.7.1159.CrossRefPubMed
5.
go back to reference Shojania KG, Ranji SR, McDonald KM, et al: Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA. 2006, 296: 427-440. 10.1001/jama.296.4.427.CrossRefPubMed Shojania KG, Ranji SR, McDonald KM, et al: Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA. 2006, 296: 427-440. 10.1001/jama.296.4.427.CrossRefPubMed
6.
go back to reference Pimouguet C, Le Goff M, Thiébaut R, Dartigues JF, Helmer C: Effectiveness of disease-management programs for improving diabetes care: a meta-analysis. CMAJ. 2011, 183 (2): E115-E127. 10.1503/cmaj.091786.CrossRefPubMedPubMedCentral Pimouguet C, Le Goff M, Thiébaut R, Dartigues JF, Helmer C: Effectiveness of disease-management programs for improving diabetes care: a meta-analysis. CMAJ. 2011, 183 (2): E115-E127. 10.1503/cmaj.091786.CrossRefPubMedPubMedCentral
7.
go back to reference Loveman E, Cave C, Green C, Royle P, Dunn N, Waugh N: The clinical and cost-effectiveness of patient education models for diabetes: a systematic review and economic evaluation. Health Technol Assess. 2003, 7 (22): iii. 1-190.CrossRef Loveman E, Cave C, Green C, Royle P, Dunn N, Waugh N: The clinical and cost-effectiveness of patient education models for diabetes: a systematic review and economic evaluation. Health Technol Assess. 2003, 7 (22): iii. 1-190.CrossRef
8.
go back to reference Vijgen SMC, Hoogendoorn M, Baan CA, de Wit GA, Limburg W, Feenstra TL: Cost effectiveness of preventive interventions in type 2 diabetes mellitus: a systematic literature review. Pharmacoeconomics. 2006, 24 (5): 425(17)-CrossRef Vijgen SMC, Hoogendoorn M, Baan CA, de Wit GA, Limburg W, Feenstra TL: Cost effectiveness of preventive interventions in type 2 diabetes mellitus: a systematic literature review. Pharmacoeconomics. 2006, 24 (5): 425(17)-CrossRef
9.
go back to reference Urbanski P, Wolf A, Herman WH: Cost-effectiveness of diabetes education. J Am Diet Assoc. 2008, 108: S6-S11.CrossRefPubMed Urbanski P, Wolf A, Herman WH: Cost-effectiveness of diabetes education. J Am Diet Assoc. 2008, 108: S6-S11.CrossRefPubMed
10.
go back to reference Duke SA, Colagiuri S, Colagiuri R: Individual patient education for people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2009, 21 (1): CD005268-Review. PubMed PMID: 19160249 Duke SA, Colagiuri S, Colagiuri R: Individual patient education for people with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2009, 21 (1): CD005268-Review. PubMed PMID: 19160249
11.
go back to reference Steinsbekk A, Rygg LØ, 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, 12: 213-10.1186/1472-6963-12-213.CrossRefPubMedPubMedCentral Steinsbekk A, Rygg LØ, 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, 12: 213-10.1186/1472-6963-12-213.CrossRefPubMedPubMedCentral
12.
go back to reference Liang X, Wang Q, Yang X, Cao J, Chen J, Mo X, et al: Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis. Diabet Med. 2011, 28 (4): 455-463. 10.1111/j.1464-5491.2010.03180.x.CrossRefPubMed Liang X, Wang Q, Yang X, Cao J, Chen J, Mo X, et al: Effect of mobile phone intervention for diabetes on glycaemic control: a meta-analysis. Diabet Med. 2011, 28 (4): 455-463. 10.1111/j.1464-5491.2010.03180.x.CrossRefPubMed
13.
go back to reference Wu L, Forbes A, Griffiths P, Milligan P, While A: Telephone follow-up to improve glycaemic control in patients with type 2 diabetes: systematic review and meta-analysis of controlled trials. Diabet Med. 2010, 27 (11): 1217-25. 10.1111/j.1464-5491.2010.03113.x.CrossRefPubMed Wu L, Forbes A, Griffiths P, Milligan P, While A: Telephone follow-up to improve glycaemic control in patients with type 2 diabetes: systematic review and meta-analysis of controlled trials. Diabet Med. 2010, 27 (11): 1217-25. 10.1111/j.1464-5491.2010.03113.x.CrossRefPubMed
14.
go back to reference Ramadas A, Quek KF, Chan CKY, Oldenburg B: Web-based interventions for the management of type 2 diabetes mellitus: a systematic review of recent evidence. Int J Med Inform. 2011, 80 (6): 389-405. 10.1016/j.ijmedinf.2011.02.002.CrossRefPubMed Ramadas A, Quek KF, Chan CKY, Oldenburg B: Web-based interventions for the management of type 2 diabetes mellitus: a systematic review of recent evidence. Int J Med Inform. 2011, 80 (6): 389-405. 10.1016/j.ijmedinf.2011.02.002.CrossRefPubMed
15.
go back to reference Walker EA, Shmukler C, Ullman R, Blanco E, Scollan-Koliopoulus M, Cohen HW: Results of a successful telephonic intervention to improve diabetes control in urban adults: a randomized trial. Diabetes Care. 2011, 34 (1): 2-7. 10.2337/dc10-1005.CrossRefPubMedPubMedCentral Walker EA, Shmukler C, Ullman R, Blanco E, Scollan-Koliopoulus M, Cohen HW: Results of a successful telephonic intervention to improve diabetes control in urban adults: a randomized trial. Diabetes Care. 2011, 34 (1): 2-7. 10.2337/dc10-1005.CrossRefPubMedPubMedCentral
16.
go back to reference Norris SL, Chowdhury FM, Van Le K, Horsley T, Brownstein JN, Zhang X, Jack L, Satterfield DW: Effectiveness of community health workers in the care of persons with diabetes. Diabet Med. 2006, 23 (5): 544-556. 10.1111/j.1464-5491.2006.01845.x.CrossRefPubMed Norris SL, Chowdhury FM, Van Le K, Horsley T, Brownstein JN, Zhang X, Jack L, Satterfield DW: Effectiveness of community health workers in the care of persons with diabetes. Diabet Med. 2006, 23 (5): 544-556. 10.1111/j.1464-5491.2006.01845.x.CrossRefPubMed
17.
go back to reference Dale J, Caramlau I, Sturt J, Friede T, Walker R: Telephone peer-delivered intervention for diabetes motivation and support: the telecare exploratory RCT, UK. Patient Educ Couns. 2009, 75 (1): 91-98. 10.1016/j.pec.2008.09.014.CrossRefPubMed Dale J, Caramlau I, Sturt J, Friede T, Walker R: Telephone peer-delivered intervention for diabetes motivation and support: the telecare exploratory RCT, UK. Patient Educ Couns. 2009, 75 (1): 91-98. 10.1016/j.pec.2008.09.014.CrossRefPubMed
19.
go back to reference Hutchison AJ, Breckon JD: A review of telephone coaching services for people with long-term conditions. J Telemed Telecare. 2011, 17: 451-458. 10.1258/jtt.2011.110513.CrossRefPubMed Hutchison AJ, Breckon JD: A review of telephone coaching services for people with long-term conditions. J Telemed Telecare. 2011, 17: 451-458. 10.1258/jtt.2011.110513.CrossRefPubMed
21.
go back to reference Vale MJ, Jelinek MV, Best JD, Dart AM, Grigg LE, Hare DL, Ho BP, Newman RW, McNeil JJ, Group CS: Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease. Arch Intern Med. 2003, 163: 2775-2783. 10.1001/archinte.163.22.2775. doi:10.1001/archinte.163.22.2775CrossRefPubMed Vale MJ, Jelinek MV, Best JD, Dart AM, Grigg LE, Hare DL, Ho BP, Newman RW, McNeil JJ, Group CS: Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease. Arch Intern Med. 2003, 163: 2775-2783. 10.1001/archinte.163.22.2775. doi:10.1001/archinte.163.22.2775CrossRefPubMed
22.
go back to reference Vale MJ, Jelinek MV, Best JD, Santamaria JD: Coaching patients with coronary heart disease to achieve the target cholesterol: a method to bridge the gap between evidence-based medicine and the “real world”–randomized controlled trial. J Clin Epidemiol. 2002, 55: 245-252. 10.1016/S0895-4356(01)00460-7. doi:10.1016/S0895-4356(01)00460-7CrossRefPubMed Vale MJ, Jelinek MV, Best JD, Santamaria JD: Coaching patients with coronary heart disease to achieve the target cholesterol: a method to bridge the gap between evidence-based medicine and the “real world”–randomized controlled trial. J Clin Epidemiol. 2002, 55: 245-252. 10.1016/S0895-4356(01)00460-7. doi:10.1016/S0895-4356(01)00460-7CrossRefPubMed
24.
go back to reference Pozzilli P, Leslie RD, Chan J, De Fronzo R, Monnier L, Raz I, Del Prato S: The A1C and ABCD of glycaemia management in type 2 diabetes: a physician’s personalized approach. Diabetes Metab Res Rev. 2010, 26 (4): 239-244. 10.1002/dmrr.1092.CrossRefPubMed Pozzilli P, Leslie RD, Chan J, De Fronzo R, Monnier L, Raz I, Del Prato S: The A1C and ABCD of glycaemia management in type 2 diabetes: a physician’s personalized approach. Diabetes Metab Res Rev. 2010, 26 (4): 239-244. 10.1002/dmrr.1092.CrossRefPubMed
25.
go back to reference Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Filardi PP, Riccardi G, Storey RF, Wood D, European Association for Cardiovascular Prevention & Rehabilitation: ESC Committee for Practice Guidelines (CPG) 2008–2010 and 2010–2012 Committees. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011, 32 (14): 1769-1818.CrossRefPubMed Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Filardi PP, Riccardi G, Storey RF, Wood D, European Association for Cardiovascular Prevention & Rehabilitation: ESC Committee for Practice Guidelines (CPG) 2008–2010 and 2010–2012 Committees. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011, 32 (14): 1769-1818.CrossRefPubMed
27.
go back to reference Noordzij M, Tripepi G, Dekker FW, Zoccali C, Tanck MW, Jager KJ: Sample size calculations: basic principles and common pitfalls. Nephrol Dial Transplant. 2010, 25 (5): 1388-1393. 10.1093/ndt/gfp732. doi: 10.1093/ndt/gfp732. Epub 2010 Jan 12. Erratum in: Nephrol Dial Transplant. 2010 Oct;25(10):3461–2CrossRefPubMed Noordzij M, Tripepi G, Dekker FW, Zoccali C, Tanck MW, Jager KJ: Sample size calculations: basic principles and common pitfalls. Nephrol Dial Transplant. 2010, 25 (5): 1388-1393. 10.1093/ndt/gfp732. doi: 10.1093/ndt/gfp732. Epub 2010 Jan 12. Erratum in: Nephrol Dial Transplant. 2010 Oct;25(10):3461–2CrossRefPubMed
28.
go back to reference Ramsey S, Willke R, Briggs A, Brown R, Buxton M, Chawla A, Cook J, Glick H, Liljas B, Petitti D, Reed S: Good research practices for cost-effectiveness analysis alongside clinical trials: the ISPOR RCT-CEA Task Force report. Value Health. 2005, 8 (5): 521-533. 10.1111/j.1524-4733.2005.00045.x.CrossRefPubMed Ramsey S, Willke R, Briggs A, Brown R, Buxton M, Chawla A, Cook J, Glick H, Liljas B, Petitti D, Reed S: Good research practices for cost-effectiveness analysis alongside clinical trials: the ISPOR RCT-CEA Task Force report. Value Health. 2005, 8 (5): 521-533. 10.1111/j.1524-4733.2005.00045.x.CrossRefPubMed
29.
go back to reference Drummond MF, Sculpher MJ, Torrance GW, O’Brien B, Stoddart GL: Methods for the economic evaluation of health care programmes. 2005, Oxford: Oxford University Press Drummond MF, Sculpher MJ, Torrance GW, O’Brien B, Stoddart GL: Methods for the economic evaluation of health care programmes. 2005, Oxford: Oxford University Press
30.
go back to reference Cleemput I, Neyt M, Van de Sande S, Thiry N: Belgian guidelines for economic evaluations and budget impact analyses: second edition. Health Technology Assessment (HTA). 2012, Brussels: Belgian Health Care Knowledge Centre(KCE), KCE Report 183C. D/2012/10.273/54 Cleemput I, Neyt M, Van de Sande S, Thiry N: Belgian guidelines for economic evaluations and budget impact analyses: second edition. Health Technology Assessment (HTA). 2012, Brussels: Belgian Health Care Knowledge Centre(KCE), KCE Report 183C. D/2012/10.273/54
31.
go back to reference Fixsen DL, Naoom SF, Blase KA, Friedman RM, Wallace F: Implementation research: a synthesis of the literature. 2005, Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231) Fixsen DL, Naoom SF, Blase KA, Friedman RM, Wallace F: Implementation research: a synthesis of the literature. 2005, Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231)
32.
go back to reference Brazier J, Tsuchiya A: Preference-based condition-specific measures of health: what happens to cross programme comparability?. Health Econ. 2010, 19 (2): 125-129. 10.1002/hec.1580.CrossRefPubMed Brazier J, Tsuchiya A: Preference-based condition-specific measures of health: what happens to cross programme comparability?. Health Econ. 2010, 19 (2): 125-129. 10.1002/hec.1580.CrossRefPubMed
Metadata
Title
Nurse-led telecoaching of people with type 2 diabetes in primary care: rationale, design and baseline data of a randomized controlled trial
Authors
Irina Odnoletkova
Geert Goderis
Frank Nobels
Bert Aertgeerts
Lieven Annemans
Dirk Ramaekers
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2014
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-15-24

Other articles of this Issue 1/2014

BMC Primary Care 1/2014 Go to the issue