The aim of this study is to evaluate the effectiveness of reorganization in Primary Health Care teams and individualized glycemic targets for type 2 diabetes.
The prevalence of diabetes is increasing in parallel with the obesity epidemic. Diabetes is, therefore, a costly disease for individuals and healthcare system, generating expenses in its management and its complications. Also, it has significant social cost related to reduction of productivity. This study will evaluate the effectiveness of a multimodal intervention for Primary Health Care (PHC) teams to increase the nurse clinical role and implement individualized glycemic targets and care plan for type 2 diabetes through a pragmatic cluster-randomized clinical trial, with 1:1 allocation of health units in Porto Alegre, Brazil. Two study arms will be evaluated: 1) intervention group: will receive a set of proposed actions (redistribution of diabetes care between nurses and physicians, use of the individualized glycemic target calculator and implementation of care recommendations); 2) control group: usual follow-up in PHC.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
408
It will be proposed that nurses and physician share the clinical care of patients with type 2 diabetes, with complementing actions
Define the target of individualized glycemic treatment for patients with the support of a tool on the website, which will encourage the intensification and de-intensification of treatment when appropriate
It will be proposed to carry out the minimum necessary assessments that, annually, nurses and physicians must do to ensure the adequacy of quality indicators in the care of diabetes in the PHC
Ana Maria Frölich Matzenbacher
Porto Alegre, Rio Grande do Sul, Brazil
Number of patients who achieved individualized target HbA1c
Number of patients who achieved the individualized target HbA1c defined at baseline
Time frame: 12 months
Percentage of clinical consultations carried out by nurses
Proportion of nursing consultations in relation to the total number of consultations (nurse and physician)
Time frame: 12 months
Foot evaluation
Total number of nursing consultations in which the feet were evaluated
Time frame: 12 months
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Primary care health teams will follow their rotine care of type 2 diabetes