Journal Article

Protocol for a randomised controlled trial to evaluate the effectiveness of the diabetes community exercise and education programme (DCEP) for long-term management of diabetes

Gray, Andrew R, Mann, Jim, Scarth, Bonnie, Doolan-Noble, Fiona, Mani, Ramakrishnan, Jayakaran, Prasath, Hale, Leigh, Stokes, Tim, Higgs, Christopher, Sullivan, Trudy

2019

Overview

IntroductionType 2 diabetes is common in Māori and Pacific peoples and in those living in areas of high socioeconomic deprivation in New Zealand (NZ). People with type 2 diabetes often have multimorbidity, which makes their diabetes management more complex. The Diabetes Community Exercise and Education Programme (DCEP) is an interprofessional, patient-centred, whānau (family)-supported package of care specifically developed to engage with Māori and Pacific people and those living in deprived areas. We have previously demonstrated the feasibility and acceptability of the DCEP. This study aims to determine the effectiveness and cost-effectiveness of the DCEP through a pragmatic randomised controlled trial (RCT).Methods and analysis220 adults (age ≥35 years) with type 2 diabetes will be recruited from general practices in the lower South Island of NZ (Dunedin and Invercargill) to participate in an RCT. Participants will be randomised to intervention (DCEP) and control (usual care) groups. The DCEP participants will have their exercise goals agreed on with a physiotherapist and nurse and will attend two 90 min exercise and education sessions per week for 12 weeks. The primary outcome measure is blood glucose control (glycated haemoglobin). Secondary outcome measures include quality of life assessed using the Audit of Diabetes-Dependent Quality of Life questionnaire. Data will be collected at four time points: baseline, end of the 12-week intervention (3 months), 6 months postintervention (9 months) and 12 months after the intervention ends (15 months). We will also conduct a cost-effectiveness analysis and a qualitative process evaluation.Ethics and disseminationThe study has been approved by the Health and Disability Ethics Committee, Ministry of Health (HDEC17/CEN/241/AM01). A key output will be the development of an evidence-based training package to facilitate implementation of the DCEP in other NZ regions.Trial registration numberACTRN 12617001624370 p; Pre-results.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Blood pressure / Community Health Centers / Comorbidity / Cost analysis / Cost-Benefit Analysis / Diabetes / Diabetes Mellitus, Type 2 - therapy / Education / Evidence-based medicine / Exercise / Exercise Therapy / Feasibility studies / Glycated Hemoglobin A - analysis / Health Services Research / Humans / Long-Term Care / Managerial skills / Multicenter Studies as Topic / New Zealand / Patient Education as Topic / Patient-centered care / Physical fitness / Pragmatic Clinical Trials as Topic / Program Evaluation / Quality of Life / Questionnaires / Surveys and Questionnaires / Systematic review