Evidence map›Paper›PMID 28151941›Full record

Trial reportPloS one2017

Does Training and Support of General Practitioners in Intensive Treatment of People with Screen-Detected Diabetes Improve Medication, Morbidity and Mortality in People with Clinically-Diagnosed Diabetes? Investigation of a Spill-Over Effect in a Cluster RCT.

Morten Charles, Mette V Skriver, Simon J Griffin, Rebecca K Simmons, Daniel R Witte, Else-Marie Dalsgaard, Torsten Lauritzen, Annelli Sandbæk

Registry-linked trialAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00237549 (The ADDITION Study. Anglo-Danish-Dutch Study of Intensive Treatment In PeOple With screeN Detected Diabetes in Primary Care), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00237549 nacompletednot on this map

The ADDITION Study. Anglo-Danish-Dutch Study of Intensive Treatment In PeOple With screeN Detected Diabetes in Primary Care

TypeinterventionalSponsorUniversity of AarhusRan2001 to 2009Enrolled3,057ConditionsType 2 DiabetesArmsoptimised treatment
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Screening for type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2020
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Morten CharlesDepartment of Public Health, Section of General Practice, Aarhus University, Denmark.ORCID http://orcid.org/0000-0003-0327-9564
Mette V SkriverDepartment of Public Health, Section of Epidemiology, Aarhus University, Denmark.
Simon J GriffinPrimary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
Rebecca K SimmonsDepartment of Public Health, Section of General Practice, Aarhus University, Denmark.
Daniel R WitteDepartment of Public Health, Section of Epidemiology, Aarhus University, Denmark.
Else-Marie DalsgaardDepartment of Public Health, Section of General Practice, Aarhus University, Denmark.
Torsten LauritzenDepartment of Public Health, Section of General Practice, Aarhus University, Denmark.
Annelli SandbækDepartment of Public Health, Section of General Practice, Aarhus University, Denmark.

Funding

Medical Research Council MC_UU_12015/4
6 · The paper itself

Abstract

introductionVery few studies have examined the potential spill-over effect of a trial intervention in general practice. We investigated whether training and support of general practitioners in the intensive treatment of people with screen-detected diabetes improved rates of redeemed medication, morbidity and mortality in people with clinically-diagnosed diabetes.

methodsThis is a secondary, post-hoc, register-based analysis linked to a cluster randomised trial. In the ADDITION-Denmark trial, 175 general practices were cluster randomised (i) to routine care, or (ii) to receive training and support in intensive multifactorial treatment of individuals with screen-detected diabetes (2001 to 2009). Using national registers we identified all individuals who were diagnosed with clinically incident diabetes in the same practices over the same time period. (Patients participating in the ADDITION trial were excluded). We compared rates of redeemed medication, a cardiovascular composite endpoint, and all-cause mortality between the routine care and intensive treatment groups.

resultsIn total, 4,107 individuals were diagnosed with clinically incident diabetes in ADDITION-Denmark practices between 2001 and 2009 (2,051 in the routine care group and 2,056 in the intensive treatment group). There were large and significant increases in the proportion of patients redeeming cardio-protective medication in both treatment groups during follow-up. After a median of seven years of follow-up, there was no difference in the incidence of a composite cardiovascular endpoint (HR 1.15, 95% CI 0.95 to 1.38) or all-cause mortality between the two groups (HR 1.08, 95% CI 0.94 to 1.23). DISCUSSION: There was no evidence of a spill-over effect from an intervention promoting intensive treatment of people with screen-detected diabetes to those with clinically-diagnosed diabetes. Overall, the proportion of patients redeeming cardio-protective medication during follow-up was similar in both groups.

trial registrationClinicalTrials.gov NCT00237549.

Indexed as

General PractitionersIncidental FindingsAdultAgedDenmarkDiabetes MellitusFemaleGeneral PracticeHumansMaleMass ScreeningMiddle Aged

Identifiers

PMID28151941
PMCPMC5289474

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.