一项多因素干预改善成人2型糖尿病合并当前或既往糖尿病足溃疡患者心血管结局:多中心随机对照试验方案(MiFoot研究)

IF 3.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Tolu Onuwe, Patrick J. Highton, David Batchelor, Alan Brennan, Molly Caba, Melanie J. Davies, Mark P. Funnell, Frances Game, Clare L. Gillies, Agnieszka Glab, Laura J. Gray, Edward Gregg, Michelle Hadjiconstantinou, Vicky Hall, Vicki Johnson, John R. Petrie, Dan Pollard, Hannah Rowntree, Solomon Tesfaye, Jonathan Valabhji, David Webb, Francesco Zaccardi, Kamlesh Khunti
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引用次数: 0

摘要

背景:在英国,糖尿病相关性足溃疡(DFUD)的患病率为6.3%,心血管疾病(CVD)是导致DFUD患者死亡的主要原因。本研究旨在评估多因素干预对降低成人2型糖尿病(T2D)和DFUD患者CVD事件和死亡率的有效性。方法:MiFoot研究是一项多中心、实用的随机对照试验,旨在测试干预措施与常规护理相比的有效性和成本效益,其中包括内部可行性研究和过程评估。说英语的成年人(≥18岁;n = 392)患有T2D和当前/既往(5年内)DFUD的患者将从英国多个地点招募,并按1:1随机分为干预组(MiFoot多因素干预加常规护理)或对照组(常规护理),并在基线、12个月和24个月随访时收集数据。MiFoot干预包括与保健医生进行个性化评估,以优化治疗并评估身体活动参与的适宜性;以群体为基础的疾病自我管理教育和身体活动课程;还有一个基于数字的项目,包括与群体相关的主题、体育活动指导和同伴支持功能。主要终点是延长24个月的主要不良心血管事件(MACE,即心肌梗死、卒中、心血管死亡、外周动脉搭桥、冠状动脉搭桥、冠状动脉血管成形术或外周动脉血管成形术)。讨论:本研究将为多因素干预在T2D和DFUD极高高危人群中预防或减缓cvd相关并发症进展的可行性、临床有效性和成本效益提供证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A multifactorial intervention to improve cardiovascular outcomes in adults with type 2 diabetes and current or previous diabetic foot ulcer disease: Protocol for a multi-centre randomised control trial (MiFoot study)

Background

In the United Kingdom, the prevalence of diabetes-related foot ulcer disease (DFUD) is 6.3%, and cardiovascular disease (CVD) is the leading cause of mortality in people with DFUD. This study aims to evaluate the effectiveness of a multifactorial intervention to reduce CVD events and mortality in adults with type 2 diabetes (T2D) and DFUD.

Methods

The MiFoot study is a multi-centre, pragmatic randomised controlled trial to test intervention effectiveness and cost-effectiveness compared to usual care that will include an internal feasibility study and a process evaluation. English-speaking adults (≥18 years; n = 392) with T2D and current/previous (within 5 years) DFUD will be recruited from multiple sites across the United Kingdom and randomised 1:1 to intervention (MiFoot multifactorial intervention plus usual care) or control (usual care), with data collected at baseline, 12- and 24-month follow-up. The MiFoot intervention comprises an individualised assessment with a healthcare practitioner to optimise treatment and assess the suitability of physical activity participation; group-based disease self management education and physical activity sessions; and a digital-based programme, consisting of cohort-relevant topics, physical activity guidance and peer support functionality. The primary outcome will be extended major adverse cardiovascular events (MACE, i.e. myocardial infarction, stroke, cardiovascular death, peripheral arterial bypass, coronary artery bypass, coronary angioplasty or peripheral artery angioplasty) at 24 months.

DISCUSSION

This study will provide evidence on the feasibility and clinical effectiveness, and cost-effectiveness of a multifactorial intervention to prevent or slow the progression of CVD-related complications in the extremely high-risk population with T2D and DFUD.

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来源期刊
Diabetic Medicine
Diabetic Medicine 医学-内分泌学与代谢
CiteScore
7.20
自引率
5.70%
发文量
229
审稿时长
3-6 weeks
期刊介绍: Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
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