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NUrse-led COntinuum of care for people with Diabetes and prediabetes (NUCOD) in Nepal: study protocol for a cluster randomized controlled trial

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Authors
Xu, Dong ( R; Dev, Rubee; Shrestha, Abha; Zhang, Lingling; Shrestha, Archana; Shakya, Pushpanjali; Hughes, James P; Shakya, Prabin R; Li, Jinghua; Liao, Jing; Karmacharya, Biraj M
Issue Date
2020-05-29
Publisher
BMC
Citation
Trials. 2020 May 29;21(1):442
Keywords
Continuum of careDiabetesPrediabetesRandomized controlled trialImplementation
Abstract
Background
The purpose of this study will be to improve diabetes prevention, access to care and advocacy through a novel cost-effective nurse-led continuum of care approach that incorporates diabetes prevention, awareness, screening and management for low-income settings, and furthermore utilizes the endeavor to advocate for establishing a standard diabetes program in Nepal.

Methods
We will conduct a two-arm, parallel group, stratified cluster randomized controlled trial of the NUrse-led COntinuum of care for people with Diabetes (N1 = 200) and prediabetes (N2 = 1036) (NUCOD) program, with primary care centers (9 outreach centers and 17 government health posts) as a unit of randomization. The NUCOD program will be delivered through the trained diabetes nurses in the community to the intervention group and the outcomes will be compared with the usual treatment group at 6 and 12 months of the intervention. The primary outcome will be the change in glycated hemoglobin (HbA1c) level among diabetes individuals and progression to type 2 diabetes among prediabetes individuals, and implementation outcomes measured using the RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework. Outcomes will be analyzed on an intention-to-treat basis.

Discussion
The results of this trial will provide information about the effectiveness of the NUCOD program in improving clinical outcomes for diabetes and prediabetes individuals, and implementation outcomes for the organization. The continuum of care model can be used for the prevention and management of diabetes and other noncommunicable diseases within and beyond Nepal with similar context.

Trial registration
ClinicalTrials.gov, NCT04131257. Registered on 18 October 2019.
ISSN
1745-6215
Language
English
URI
http://hdl.handle.net/10371/168598
DOI
https://doi.org/10.1186/s13063-020-04372-5
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College of Dentistry/School of Dentistry (치과대학/치의학대학원)Dept. of Dentistry (치의학과)Journal Papers (저널논문_치의학과)
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