A Prospective Study on Diabetes Management Through an Integrated Delivery System (DMIDS)
- To demonstrate a feasible hospital-based diabetic shared care model in Taiwan.
- To compare effectiveness of diabetes control between patients receiving case management provided by a health manager and patients receiving usual care.
- To determine the optimal level of glucose, blood pressure and lipids in control of diabetes in Taiwan.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Subject)
|Official Title:||A Prospective Study on Diabetes Management Through an Integrated Delivery System|
- Through the health manager's coordination and consultation, diabetic patients will have better glycemic control for fasting plasma glucose, HbA1c, and blood cholesterol level.
- Patients in the intervention group will have better health status such as lower hospitalization rate, shorter length of stay in hospitals, and fewer diabetic complications.
|Study Start Date:||July 2003|
|Study Completion Date:||December 2007|
|Primary Completion Date:||December 2007 (Final data collection date for primary outcome measure)|
Five general hospitals, including both public and private, are chosen as regional coordinating centers in this project. Collaborating with community physicians, project coordinating-centers randomize diabetic patients, who have signed informed consent, into either intervention or control group. While two annual comprehensive lab tests are offered to the control group, an additional package of consultations and coordinating services provided by health managers is appended to the intervention group. Qualified health managers are cultivated in five selected medical institutes to support primary care physicians in managing diabetic patients. Responsibilities of health managers include tracking and updating enrolled patients' information, providing adequate and scheduled consultations, arranging specialty referrals for patients in needs, and transferring stable patients back to their original physicians. The feasibility phase of the project implementation will last for three years and it will be followed by a phase of full-scale implementation for another two years. Glycemic control as well as health status of participants will be the indicators to evaluate outcome of the project. At the same time, the periodic measurements on glucose, blood pressures, lipids and the incidence of complications will also be analyzed to set up an optimal target for diabetic control in Taiwan.
|Kaohsiung Medical University Hospital|
|Kaohsiung, Taiwan, 80708|
|China Medical University Hospital|
|Taichung, Taiwan, 40447|
|National Cheng Kung University Hospital|
|Tainan, Taiwan, 70403|
|Tri-Services General Hospital|
|Taipei, Taiwan, 11490|
|Min-Shen General Hospital|
|Taoyuan, Taiwan, 33044|
|Principal Investigator:||Chih-Cheng Hsu, M.D, Dr. P.H||National Health Research Instiutes|
|Principal Investigator:||Hsing-Yi Chang, Ph. Dr. P.H||National Health Research Instiutes|