Study of the Impact of PROximity Support for Patients With Type 1 DIABetes Treated With an Insulin Pump or Closed Loop.
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: enhanced care model provided by Timkl, a home support provider.
- Who it may be relevant to
- Registry conditions: Diabetes Mellitus, Type 1. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- France
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
PRO-DIAB-1: Study of the Impact of PROximity Support for Patients With Type 1 DIABetes Treated With an Insulin Pump or Closed Loop.
Overview
Amidst medical innovations, many Type 1 diabetes patients using advanced therapy show improved control but still suffer from diabetes-related distress. To tackle this, the investigators propose an "enhanced care" model involving healthcare providers and pharmacists. The study compares standard and enhanced care for Type 1 adults, focusing on the pharmacist's role. The main question it aims to answer is : In patients with type 1 diabetes treated with pump or closed-loop therapy, does the improved enhanced care versus conventional layout improve diabetes-related distress at 12 months? Participants will complete a monthly online questionnaire to assess their diabetes-related distress as well as their frequency of use of standard and enhanced care as well as the associated patient satisfaction.
Detailed description
Amidst accelerating innovations in care and limited medical time, many patients with Type 1 diabetes treated by pump or closed-loop therapy appear to have improved glycaemic control, but still experience significant diabetes-related distress.
The investigators therefore propose that a new form of patient care service provided by a health service provider and the patient's pharmacist, as part of the new type of care called "enhanced care", could contribute to overcoming this challenge.
This study compares two different care services provided to adult patients with Type 1 diabetes (PwT1D) treated with an insulin pump or a closed-loop system, known as standard care and enhanced care, the main difference between which lies in the pharmacist's involvement in the enhanced care model.
The originality of this project lies in several points:
* Firstly, it involves evaluating a new care model called enhanced care, which has the original feature of including the involvement of the patient's dispensing pharmacist. * The role of home support providers in the psychological aspects of diabetes is poorly documented in the scientific literature.
Diabetes-related distress is a well-known complication, but means of prevention remain inadequate. This study integrates live collection of patient data, by the patient. Patient experience is an innovative approach that plays an increasingly important role in the evaluation of new management approaches.
* In addition to patient data, this study integrates data from pharmacists and physicians. These data will be used to compare the points of view of healthcare professionals and patients, in order to gain a precise idea of the service provided by the enhanced care. In itself, this comparison could contribute to identifying and understanding the difference in the points of view of healthcare professionals and patients. * While there is a wealth of literature demonstrating the value of pharmacist involvement in the care of Type 2 diabetic patients, such information is lacking for Type 1 diabetes. This study, aimed at investigating the impact of the pharmacist, specifically on the distress of patients undergoing highly technical treatment, is therefore original. * Finally, the design of this pragmatic, randomized study enables real-life practices to be analyzed, while maintaining the highest possible level of evidence.
Interventions
- Other enhanced care model provided by Timkl, a home support provider
A new type of care provided by timkl, a home support provider, involving nurses and the dispensing pharmacist. This approach combines the current tasks of the service provider's nurses with closer monitoring by the pharmacist, thanks to more frequent contacts and a holistic view of the patient.
Primary outcome measures
- Change in the 7-question Type-1 Diabetes Distress Score (T1-DDS-7) [Comparison: Enhanced Care vs Standard Care] [Time frame: Baseline visit (Month 0) to Final visit (Month 12)]
Secondary outcome measures (12)
- A.1 Change in the 7-question Type-1 Diabetes Distress Score (T1-DDS-7) [Comparison: Enhanced Care vs Standard Care] [Time frame: Baseline (Month 0) to Month 6]
- A.2 Change in the sub-scores of the 7-question Type-1 Diabetes Distress Score (T1-DDS-7) [Comparison: Enhanced Care vs Standard Care] [Time frame: Baseline (Month 0) to Month 12]
- A.3a Evolution of the 7-question Type-1 Diabetes Distress Score (T1-DDS-7) [Comparison: Enhanced Care vs Standard Care] [Time frame: quarterly between Baseline (Month 0) and Month 12]
- A.3b Evolution of the 2-question Diabetes Distress Score (DDS2) [Comparison: Enhanced Care vs Standard Care] [Time frame: 8 times between Baseline (Month 0) and Month 12]
- B.1a Patient overall satisfaction with services provided by the home support provider [Time frame: monthly between Baseline (Month 0) and Month 12]
- B.1b Frequency of patients' interactions with the home support provider [Time frame: monthly between Baseline (Month 0) and Month 12]
- B.1c Satisfaction with specific aspects of the services provided by the home support provider [Time frame: monthly between Baseline (Month 0) and Month 12]
- B.2a (Intervention group only) Number of pharmacy visits [Time frame: monthly between Baseline (Month 0) and Month 12]
- B.2b (Intervention group only) Duration of pharmacy visits [Time frame: monthly between Baseline (Month 0) and Month 12]
- B.2c (Intervention group only) Description of clinical or non-clinical events impacting diabetes [Time frame: monthly between Baseline (Month 0) and Month 12]
- B.3a Patients' Perceived Effectiveness of Patient-Physician Interactions (PEPPI questionnaire) [Time frame: at Month 6 and at Month 12]
- B.3b Patient Assessment of Chronic Illness Care (PACIC questionnaire) [Time frame: at Baseline (Month 0) and at Month 12]
Eligibility criteria
Inclusion criteria
- Be an adult (age ≥ 18 years)
- Have Type 1 diabetes
- Have been on closed-loop or insulin pump therapy for ≥ 6 months
- Be in moderate or high diabetes-related distress defined as a DDS2 score ≥ 6
- Be able to understand and complete questionnaires in French
- Be affiliated to the general French Social Security system
- Have an e-mail address
- Have a cell phone number
Non-inclusion criteria:
- Be deprived of liberty, under guardianship or curatorship
- Not have Internet access or a cell phone
- Have benefited or are already benefiting from the Enhanced Care program
- Participating in an interventional study on a medical device for diabetes (pump, sensors, etc.)
- Patients who are not regularly monitored in the investigating center proposing to include them, or who are likely to change centers or move to a different living area (pharmacy) within a year of inclusion.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Supportive care
Study locations
France · 1 center
- CHU Nice - Hôpital l'Archet 2 — Nice
Identifiers
NCT: NCT06050642 · PRO-DIAB-1 · 2023-A00891-44