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Diabetes Mellitus Type 2NCT07124923

Continuous Care Intervention in Primary Care to Improve Type 2 Diabetes Control in Terres de l'Ebre, Catalonia

A study testing Continuity-of-Care intervention in people with Diabetes Mellitus Type 2, run by Institut Investigacio Sanitaria Pere Virgili at 12 sites in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This randomized, parallel-group clinical trial evaluates the effectiveness of a continuity of care intervention to improve metabolic control in adults with type 2 diabetes mellitus (T2DM) in the Terres de l'Ebre health region. Read more about this study

Who is it for?
Ages 18 to 90 years
Conditions the study is for
Diabetes Mellitus Type 2
What is being tested?
Continuity-of-Care intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
7,792 participants
Where
12 sitesSpain
Study dates
20 Jul 2025to 20 Jul 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 90 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Enrollment will begin in July 2025, aligned with the initiation of training sessions for healthcare professionals (physicians and nurses).
  • Eligible participants must:
  • Be adults (≥18 years old)
  • Have an active diagnosis of T2DM documented in the eCAP primary care electronic health record system
  • Have a duration of T2DM of at least 12 months as of January 2025

Who cannot join

  • Diagnosis of type 1 diabetes mellitus (T1DM)
  • T2DM managed by a specialist at the time of inclusion
  • Current treatment with systemic corticosteroids
  • Active neoplasia (malignancy)
  • Gestational diabetes
  • Pregnancy or breastfeeding
Show all 16Show fewer
  • Diagnosis of MACA (advanced chronic disease with life expectancy <1 year)
  • Complex chronic patients (CCP)
  • Diagnosis of dementia
  • Institutionalized patients or those residing in social healthcare facilities
  • Age over 90 years
  • Age under 18 years
  • Severe psychiatric illness (e.g., psychosis, bipolar disorder, major depression)
  • History of kidney transplant
  • Undergoing dialysis
  • History of alcohol or drug abuse

Trial locations and contacts

12 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Marcela Miret Llauradó, MD contact

+0034977519100 ext. 2269

mmiretl.ebre.ics@gencat.cat

12 sites in 1 country

Spain12 sites, 12 recruiting
  • Abs Amposta

    Amposta, Tarragona, 43870

    Marcel.la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • Abs Deltebre

    Deltebre, Tarragona, 43580

    Marcel.la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • Abs Ametlla-Perelló

    El Perelló, Tarragona, 43860

    Marcel·la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • ABS FLIX

    Flix, Tarragona, 43750

    Marcel·la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • Abs Gandesa

    Gandesa, Tarragona, 43780

    Marcel.la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • Abs Ampolla-Aldea

    L'Ampolla, Tarragona, 43895

    Marcel.la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • Abs Mora La Nova

    Móra la Nova, Tarragona, 43770

    Marcel.la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • Abs La Ràpita-Alcanar

    Sant Carles de la Ràpita, Tarragona, 43540

    Marcel.la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • Abs Tortosa Est

    Tortosa, Tarragona, 43500

    Marcel·la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • Abs Tortosa Oest

    Tortosa, Tarragona, 43500

    Marcel.la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • Hospital de Tortosa Verge de la Cinta

    Tortosa, Tarragona, 43500

    Marcel·la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting
  • Abs Ulldecona

    Ulldecona, Tarragona, 43550

    Marcel·la Miret Llauradó, +34-977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat

    Recruiting

Other trials in Spain

About this study

Official title: Effectiveness of a Continuous Care Intervention by the Endocrinology and Nutrition Service in Primary Care to Improve the Control of Type 2 Diabetes Mellitus in Terres de l'Ebre, Catalonia

This randomized, parallel-group clinical trial evaluates the effectiveness of a continuity of care intervention to improve metabolic control in adults with type 2 diabetes mellitus (T2DM) in the Terres de l'Ebre health region. The intervention, led by the Endocrinology Service at Hospital de Tortosa Verge de la Cinta (HTVC), involves structured, multidisciplinary training and feedback provided by endocrinologists and nurse educators to primary care professionals. Training modules combine theoretical and practical content focused on current diabetes management.

Primary care centers are randomized to intervention or control arms. Eligible participants are adult patients with an active diagnosis of T2DM for at least 12 months as of January 2025, registered in the eCAP system. All primary care professionals in intervention centers participate in the training.

The intervention is conducted over one year (July 2025-July 2026). Outcomes are assessed at baseline, 6, 12, and 24 months. The primary outcome is HbA1c; secondary outcomes include other health indicators, professional knowledge and engagement, and organizational variables. A qualitative component gathers professional input before and after the intervention to inform future implementation. All data are anonymized to ensure confidentiality.

Read the detailed description

T2DM is a highly prevalent chronic disease, accounting for approximately 90% of all diabetes cases, and is primarily managed in the primary care setting. The complexity of optimizing metabolic control in T2DM has increased, as current guidelines recommend a multifactorial approach that addresses not only glycemic control but also cardiovascular risk and multimorbidity. Glycosylated hemoglobin (HbA1c) remains the principal marker for assessing glycemic control and predicting diabetes-related complications.

Despite the availability of evidence-based clinical practice guidelines, their implementation in routine care is often suboptimal due to factors such as limited time, resources, clinical inertia, and challenges with patient adherence. Interventions targeting healthcare professionals and organizational processes-such as structured training, audit and feedback, and system-level changes-have shown promise in improving metabolic outcomes, particularly among patients with suboptimal glycemic control.

This study is a randomized, parallel-group clinical trial designed to evaluate the effectiveness of a continuity of care intervention led by the Endocrinology Service at HTVC, in collaboration with primary care centers in the Terres de l'Ebre health region. Primary care centers will be randomized to either the intervention or control group.

The intervention consists of structured, multidisciplinary training and feedback provided by endocrinologists and nurse educators to primary care physicians and nurses. Training sessions are delivered in modules that combine theoretical and practical content, with a focus on up-to-date diabetes management strategies and the needs of each primary care center. The endocrinology team includes endocrinologists, nurse educators, and a specialist nurse from the Diabetic Foot Unit. Training will be delivered onsite at intervention centers in scheduled sessions over a one-year period.

A qualitative component is integrated into the study, involving focus groups with participating primary care professionals before and after the intervention. This aims to gather insights on professional perspectives, identify barriers and facilitators, and inform the adaptation and future implementation of the intervention.

The primary outcome is improvement in HbA1c, with secondary outcomes including additional patient health indicators, professional knowledge and engagement, and organizational variables. Data collection will occur at baseline, 6, 12, and 24 months. All data will be anonymized to ensure confidentiality.

This study aims to provide evidence on the effectiveness of a multidisciplinary, continuity of care intervention in improving metabolic control for adults with T2DM in a real-world primary care setting.

Being tested
Continuity-of-Care intervention
Keywords
HbA1c, Primary Care, Continuity of Care, Training
Medical subject headings
Diabetes Mellitus, Type 2

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Continuity-of-Care interventionOther

    The intervention is a structured, multidisciplinary training and feedback program led by the Endocrinology Service at HTVC in collaboration with primary care centers in Terres de l'Ebre.

    Four endocrinologists and four nurses (three educators and one diabetic foot referent) will provide onsite training to primary care physicians and nurses. Training includes six modules with theoretical and practical components, covering T2DM management, cardiovascular risk reduction, and diabetic foot care. Sessions will be held biweekly and delivered by doctor-nurse teams rotating through the participating primary care centers from July 2025 to July 2026, with each center receiving a total of 15 sessions per year.

    The program also includes regular feedback to professionals on clinical performance and patient outcomes, adapting content to each center's needs. A qualitative component, involving focus groups before and after the intervention, will gather feedback and inform future implementation.

Study groups in NCT07124923
Study groupRoleWhat they receive
Continuity-of-Care Training for Primary Care ProfessionalsExperimentalA parallel-group randomized clinical trial will be conducted in 11 primary care centers of the Terres de l'Ebre area (Catalan Health Institute). Randomization was performed by the data extractor before pseudonymization using simple randomization (1:1 ratio), generating values 0 and 1. Centers scoring <0.5 were assigned to the control group; those ≥0.5 to the intervention group, resulting in 5 intervention and 6 control centers.
Receives: Other: Continuity-of-Care intervention
Usual Care (No Continuity-of-Care Training)No interventionPrimary care professionals provide care according to current local standard practices without receiving specific training on continuity-of-care strategies.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. HbA1c

    Evaluate the percentage improvement in HbA1c levels in relation to healthcare professionals' attendance at training sessions.

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

Secondary outcomes (12)
  1. Change in total cholesterol and LDL cholesterol

    Mean change in total and LDL cholesterol levels from baseline, measured in mg/dL.

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

  2. Change in systolic and diastolic blood pressure

    Mean change in systolic and diastolic blood pressure from baseline, measured in mmHg.

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

  3. Change in smoking status

    Change in smoking status (current, former, never) and number of cigarettes smoked per day.

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

  4. Change in Body Mass Index (BMI)

    Mean change in BMI (Kg/m2) from baseline. BMI will be calculated as weight in kilograms divided by height in meters squared.

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

  5. Percentage of participants adherent to screening protocol for T2DM complications

    Percentage of participants who complete all recommended screenings for chronic complications of T2DM, including screening for retinopathy, nephropathy, foot examination, and cardiovascular assessment.

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

  6. Referrals to the Diabetic Foot Unit

    Evaluate the association between attendance at diabetic foot training and referrals to the Diabetic Foot Unit.

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

  7. Emergency assistance for metabolic decompensations

    Evaluate whether patients present to emergency care with a diagnosis of metabolism and nutrition disorder according to CIE-10 ( CIE-10 E00-E90)

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

  8. Number of hospital referrals from primary care

    Evaluate the number of hospital referrals to endocrinology specialty consultation after primary care attendance.

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

  9. Medication changes

    Assess the association between professional attendance at training and medication changes.

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

  10. Number of patient visits to primary care

    Evaluate the number of patient visits to primary care, stratified by nursing and physician attendance.

    Measured: At enrollment, 6, 12, and 24 months after enrollment.

  11. Professional perceptions of relevance, feasibility and impact of the Continuity-of-Care intervention

    Professional perceptions of the Continuity-of-Care intervention will be assessed through pre- and post-intervention focus groups. Focus groups will be conducted with professionals from different disciplines (primary care doctors and nurses). Transcripts will be analyzed using thematic content analysis to assess perceptions of relevance, feasibility, and impact of the intervention.

    Measured: Pre-intervention and 1 month post-intervention

  12. Professional experiences with implementing the Continuity-of-Care intervention, including perceived barriers and facilitators

    Professional experiences with implementing the Continuity-of-Care intervention will be assessed through pre- and post-intervention focus groups. Focus groups will be conducted with professionals from different disciplines (primary care doctors and nurses). Transcripts will be analyzed using thematic content analysis to assess experiences related to implementation and perceived barriers/facilitators.

    Measured: Pre-intervention and 1 month post-intervention.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Aug 2025
  2. Study start20 Jul 2025
  3. Primary completion20 Jan 2026 (estimated)
  4. Study completion20 Jul 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
7,792 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07124923
Sponsor's protocol ID
009/2024
Other IDs
2024 DI 00039
Status last verified
Sep 2025
First submitted
16 Jul 2025
Last updated
8 Sep 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Data sharing will be upon request directly to the Principal Investigator.

Questions about this trial

What is this clinical trial studying?

A study testing Continuity-of-Care intervention in people with Diabetes Mellitus Type 2, run by Institut Investigacio Sanitaria Pere Virgili at 12 sites in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 8 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Marcela Miret Llauradó, MD (+0034977519100 ext. 2269, mmiretl.ebre.ics@gencat.cat), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

HbA1c (time frame: At enrollment, 6, 12, and 24 months after enrollment.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Sep 2025.

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