Improving diabetes care: Multi-component cardiovascular disease risk reduction strategies for people with diabetes in South Asia-The CARRS Multi-center Translation Trial
Publication Type:Journal Article
Source:Diabetes Research and Clinical Practice, Volume 98, Number 2, p.285-294 (2012)
Keywords:adult, article, Asia, blood pressure measurement, Cardiovascular Diseases, cardiovascular risk, cholesterol, cholesterol blood level, Confidentiality, controlled study, cost effectiveness analysis, Cost-Benefit Analysis, decision support system, diabetes mellitus, electronic medical record, evidence based medicine, feasibility study, Glucose, glucose blood level, health care delivery, health care quality, high risk patient, human, Humans, India, intervention study, major clinical study, multicenter study (topic), multicomponent cardiovascular disease risk reduction intervention, Pakistan, patient care, patient safety, qualitative analysis, quantitative analysis, randomized controlled trial (topic), risk reduction, Risk Reduction Behavior, sample size, Software, South Asia, Type 2
Aims: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in people with diabetes in South Asia. The CARRS Translation Trial tests the effectiveness, cost-effectiveness, and sustainability of a clinic-based multi-component CVD risk reduction intervention among people with diabetes in India and Pakistan. Methods: We randomly assigned 1146 adults with diabetes recruited from 10 urban clinic sites, to receive usual care by physicians or to receive an integrated multi-component CVD risk reduction intervention. The intervention involves electronic health record management, decision-support prompts to the healthcare team, and the support of a care coordinator to actively facilitate patient and provider adherence to evidence-based guidelines. The primary outcome is a composite of multiple CVD risk factor control (blood glucose and either blood pressure or cholesterol, or all three). Other outcomes include control of the individual CVD risk factors, process and patient-centered measures, cost-effectiveness, and acceptability/feasibility. Conclusion: The CARRS Translation Trial tests a low-cost diabetes care delivery model in urban South Asia to achieve comprehensive cardio-metabolic disease case-management of high-risk patients (clinicaltrials.gov number: NCT01212328). © 2012 Elsevier Ireland Ltd.
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