The Diabetes Guidelines Implementation in Hospitals Study.

• Register: Netherlands Trial Register
• Last refreshed on: 28 April 2013
• Main ID: NTR892
• Date of registration: 07/02/2007
• Primary sponsor: University Medical Center St. Radboud, Center for Quality of Care Research (WOK)
• Public title: The Diabetes Guidelines Implementation in Hospitals Study.
• Scientific title: Implementation of Guidelines on Diabetes Mellitus in Hospitals. - DIHS
• Date of first enrolment: 1/12/2000
• Target sample size: 1950
• Recruitment status: complete
• URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=892
• Study type: intervention
• Study design: Randomised: Yes; Masking: None; Control: Active; Group: Parallel; Type: 2 or more arms, randomized

Countries of recruitment

The Netherlands

Contacts

• Name: R. Dijkstra

• Name: R. Dijkstra

Key inclusion & exclusion criteria

Inclusion criteria: In 13 hospitals the first 150 patients with diabetes that came for a checkup at their internists were included.
Exclusion criteria: 1. Patients with a short (<1 year) life expectancy;

2. Pregnant patients.

Age minimum:
Age maximum:
Gender:

Health Condition(s) or Problem(s) studied

Guidelines, Diabetes Mellitus, Guideline adherence , Physician-patient interaction, Empowerment

Intervention(s)

At hospitals in the professional-directed group (n=4), the health professionals received aggregated feedback on baseline data on their patient population. During an educational meeting for internists, DSNs and dieticians, the guidelines were discussed, promoted and distributed by a national opinion leader in diabetic care. Also desktop reminder cards of key guidelines were distributed, including a nomogram to easily calculate the BMI. Internists and DSNs preferred these reminder cards to locally adapted written protocols. After six months the internists received personal benchmarked feedback on their clinical performance.

At the hospitals in the patient centred group (n=4) intervention activities were addressed to the health care professionals and to the patients. As in the other intervention group feedback was given to the professionals on baseline data. During an educational meeting with a national opinion leader, guidelines as well as the diabetes passports were introduced. Barriers and facilitators to implement the diabetes passports in the clinic were discussed. Like in the other intervention group after six months personal feedback was given to the internists only, but this time on clinical performance as well as on the use of the diabetes passport. For the patients in the patient centred group, additional educational meetings were organised in collaboration with the local patient organisations. Furthermore 4,500 diabetes passports were made available at the four hospitals and waiting room posters, reminders for the patients to bring their passports and leaflets explaining how to use the passport were distributed. The passports were introduced and given to the patients by internists or DSNs during the clinic hours.

Primary Outcome(s)

The mean HbA1c level (mmol/l) of the patients in de different intervention groups.

Secondary Outcome(s)

Clinical outcomes at the patient level:

Quality of Life SF-20 locus of control and patient satisfaction

Secondary ID(s)

ISRCTN35851744

N/A

Source(s) of Monetary Support

Dutch Ministry of Health, Welfare and Sport