Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hyp
Background Chronic disease management presents enormous challenges to the primary care workforce because of the rising epidemic of cardiovascular risk factors. The chronic care model was proven effective in improving chronic disease outcomes in developed countries, but there is little evidence of i...
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| Format: | Article |
| Language: | English |
| Published: |
BioMed Central
2014
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| Online Access: | http://psasir.upm.edu.my/id/eprint/35517/1/Study%20protocol%20of%20EMPOWER%20Participatory%20Action.pdf |
| _version_ | 1825948662335799296 |
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| author | Ramli, Anis S. Lakshmanan, Sharmila Haniff, Jamaiyah Selvarajah, Sharmini Tong, Seng Fah Bujang, Mohamad Adam Abdul Razak, Suraya Shafie, Asrul Akmal Lee, Verna K.M. Abdul Rahman, Thuhairah H. Daud, Maryam H. Ng, Kien K. Ariffin, Farnaza Abdul Hamid, Hasidah Md Yasin, Mazapuspavina Mat Nasir , Nafiza Miskan, Maizatullifah Ponniah, Jaya P.Stanley Ismail, Mastura Chan, Chun W. Abdul Rahman, Yong R. Chew, Boon How Low, Wilson H.H. |
| author_facet | Ramli, Anis S. Lakshmanan, Sharmila Haniff, Jamaiyah Selvarajah, Sharmini Tong, Seng Fah Bujang, Mohamad Adam Abdul Razak, Suraya Shafie, Asrul Akmal Lee, Verna K.M. Abdul Rahman, Thuhairah H. Daud, Maryam H. Ng, Kien K. Ariffin, Farnaza Abdul Hamid, Hasidah Md Yasin, Mazapuspavina Mat Nasir , Nafiza Miskan, Maizatullifah Ponniah, Jaya P.Stanley Ismail, Mastura Chan, Chun W. Abdul Rahman, Yong R. Chew, Boon How Low, Wilson H.H. |
| author_sort | Ramli, Anis S. |
| collection | UPM |
| description | Background
Chronic disease management presents enormous challenges to the primary care workforce because of the rising epidemic of cardiovascular risk factors. The chronic care model was proven effective in improving chronic disease outcomes in developed countries, but there is little evidence of its effectiveness in developing countries. The aim of this study was to evaluate the effectiveness of the EMPOWER-PAR intervention (multifaceted chronic disease management strategies based on the chronic care model) in improving outcomes for type 2 diabetes mellitus and hypertension using readily available resources in the Malaysian public primary care setting. This paper presents the study protocol.
Methods/Design
A pragmatic cluster randomised controlled trial using participatory action research is underway in 10 public primary care clinics in Selangor and Kuala Lumpur, Malaysia. Five clinics were randomly selected to provide the EMPOWER-PAR intervention for 1 year and another five clinics continued with usual care. Each clinic consecutively recruits type 2 diabetes mellitus and hypertension patients fulfilling the inclusion and exclusion criteria over a 2-week period. The EMPOWER-PAR intervention consists of creating/strengthening a multidisciplinary chronic disease management team, training the team to use the Global Cardiovascular Risks Self-Management Booklet to support patient care and reinforcing the use of relevant clinical practice guidelines for management and prescribing. For type 2 diabetes mellitus, the primary outcome is the change in the proportion of patients achieving HbA1c < 6.5%. For hypertension without type 2 diabetes mellitus, the primary outcome is the change in the proportion of patients achieving blood pressure < 140/90 mmHg. Secondary outcomes include the proportion of patients achieving targets for serum lipid profile, body mass index and waist circumference. Other outcome measures include medication adherence levels, process of care and prescribing patterns. Patients’ assessment of their chronic disease care and providers’ perceptions, attitudes and perceived barriers in care delivery and cost-effectiveness of the intervention are also evaluated.
Discussion
Results from this study will provide objective evidence of the effectiveness and cost-effectiveness of a multifaceted intervention based on the chronic care model in resource-constrained public primary care settings. The evidence should instigate crucial primary care system change in Malaysia.
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| first_indexed | 2024-03-06T08:32:34Z |
| format | Article |
| id | upm.eprints-35517 |
| institution | Universiti Putra Malaysia |
| language | English |
| last_indexed | 2024-03-06T08:32:34Z |
| publishDate | 2014 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | upm.eprints-355172016-01-21T08:31:00Z http://psasir.upm.edu.my/id/eprint/35517/ Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hyp Ramli, Anis S. Lakshmanan, Sharmila Haniff, Jamaiyah Selvarajah, Sharmini Tong, Seng Fah Bujang, Mohamad Adam Abdul Razak, Suraya Shafie, Asrul Akmal Lee, Verna K.M. Abdul Rahman, Thuhairah H. Daud, Maryam H. Ng, Kien K. Ariffin, Farnaza Abdul Hamid, Hasidah Md Yasin, Mazapuspavina Mat Nasir , Nafiza Miskan, Maizatullifah Ponniah, Jaya P.Stanley Ismail, Mastura Chan, Chun W. Abdul Rahman, Yong R. Chew, Boon How Low, Wilson H.H. Background Chronic disease management presents enormous challenges to the primary care workforce because of the rising epidemic of cardiovascular risk factors. The chronic care model was proven effective in improving chronic disease outcomes in developed countries, but there is little evidence of its effectiveness in developing countries. The aim of this study was to evaluate the effectiveness of the EMPOWER-PAR intervention (multifaceted chronic disease management strategies based on the chronic care model) in improving outcomes for type 2 diabetes mellitus and hypertension using readily available resources in the Malaysian public primary care setting. This paper presents the study protocol. Methods/Design A pragmatic cluster randomised controlled trial using participatory action research is underway in 10 public primary care clinics in Selangor and Kuala Lumpur, Malaysia. Five clinics were randomly selected to provide the EMPOWER-PAR intervention for 1 year and another five clinics continued with usual care. Each clinic consecutively recruits type 2 diabetes mellitus and hypertension patients fulfilling the inclusion and exclusion criteria over a 2-week period. The EMPOWER-PAR intervention consists of creating/strengthening a multidisciplinary chronic disease management team, training the team to use the Global Cardiovascular Risks Self-Management Booklet to support patient care and reinforcing the use of relevant clinical practice guidelines for management and prescribing. For type 2 diabetes mellitus, the primary outcome is the change in the proportion of patients achieving HbA1c < 6.5%. For hypertension without type 2 diabetes mellitus, the primary outcome is the change in the proportion of patients achieving blood pressure < 140/90 mmHg. Secondary outcomes include the proportion of patients achieving targets for serum lipid profile, body mass index and waist circumference. Other outcome measures include medication adherence levels, process of care and prescribing patterns. Patients’ assessment of their chronic disease care and providers’ perceptions, attitudes and perceived barriers in care delivery and cost-effectiveness of the intervention are also evaluated. Discussion Results from this study will provide objective evidence of the effectiveness and cost-effectiveness of a multifaceted intervention based on the chronic care model in resource-constrained public primary care settings. The evidence should instigate crucial primary care system change in Malaysia. BioMed Central 2014 Article PeerReviewed application/pdf en http://psasir.upm.edu.my/id/eprint/35517/1/Study%20protocol%20of%20EMPOWER%20Participatory%20Action.pdf Ramli, Anis S. and Lakshmanan, Sharmila and Haniff, Jamaiyah and Selvarajah, Sharmini and Tong, Seng Fah and Bujang, Mohamad Adam and Abdul Razak, Suraya and Shafie, Asrul Akmal and Lee, Verna K.M. and Abdul Rahman, Thuhairah H. and Daud, Maryam H. and Ng, Kien K. and Ariffin, Farnaza and Abdul Hamid, Hasidah and Md Yasin, Mazapuspavina and Mat Nasir , Nafiza and Miskan, Maizatullifah and Ponniah, Jaya P.Stanley and Ismail, Mastura and Chan, Chun W. and Abdul Rahman, Yong R. and Chew, Boon How and Low, Wilson H.H. (2014) Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hyp. BMC Family Practice, 15 (1). art. no. 151. pp. 1-16. ISSN 1471-2296 10.1186/1471-2296-15-151 |
| spellingShingle | Ramli, Anis S. Lakshmanan, Sharmila Haniff, Jamaiyah Selvarajah, Sharmini Tong, Seng Fah Bujang, Mohamad Adam Abdul Razak, Suraya Shafie, Asrul Akmal Lee, Verna K.M. Abdul Rahman, Thuhairah H. Daud, Maryam H. Ng, Kien K. Ariffin, Farnaza Abdul Hamid, Hasidah Md Yasin, Mazapuspavina Mat Nasir , Nafiza Miskan, Maizatullifah Ponniah, Jaya P.Stanley Ismail, Mastura Chan, Chun W. Abdul Rahman, Yong R. Chew, Boon How Low, Wilson H.H. Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hyp |
| title | Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hyp |
| title_full | Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hyp |
| title_fullStr | Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hyp |
| title_full_unstemmed | Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hyp |
| title_short | Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hyp |
| title_sort | study protocol of empower participatory action research empower par a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hyp |
| url | http://psasir.upm.edu.my/id/eprint/35517/1/Study%20protocol%20of%20EMPOWER%20Participatory%20Action.pdf |
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