Supporting insulin initiation in type 2 diabetes in primary care: results of the Stepping Up pragmatic cluster randomised controlled clinical trial
John Furler, David O'Neal, Jane Speight, Jo-Anne Manski-Nankervis, Alexandra Gorelik, Elizabeth Holmes-Truscott, Louise Ginnivan, Doris Young, James Best, Elizabeth Patterson, Danny Liew, Leonie Segal, Carl May, Irene Blackberry
BMJ-BRITISH MEDICAL JOURNAL | BMJ PUBLISHING GROUP | Published : 2017
Objective To compare the effectiveness of a novel model of care ("Stepping Up") with usual primary care in normalising insulin initiation for type 2 diabetes, leading to improved glycated haemoglobin (HbA1c) levels.Design Cluster randomised controlled trial.Setting Primary care practices in Victoria, Australia, with a practice nurse and at least one consenting eligible patient (HbA1c ≥7.5% with maximal oral treatment).Participants 266 patients with type 2 diabetes and 74 practices (mean cluster size 4 (range 1-8) patients), followed up for 12 months.Intervention The Stepping Up model of care intervention involved theory based change in practice systems and reorientation of the roles of healt..View full abstract
Awarded by Australian National Health and Medical Research Council
The study was funded by the Australian National Health and Medical Research Council (ID 1023738) and was supported by an educational/research grant by Roche Diagnostics Australia.