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CTRI Number  CTRI/2024/03/064346 [Registered on: 18/03/2024] Trial Registered Prospectively
Last Modified On: 18/09/2024
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Biological
Behavioral
Other (Specify) [health edcuation]  
Study Design  Randomized, Parallel Group, Placebo Controlled Trial 
Public Title of Study   Telemedicine effectiveness in blood sugar control and lifestyle modification. 
Scientific Title of Study   Effectiveness of Telemedicine and Electronic Call Reminder and health Education (TECARE trial) for Diabetes : A Randomized Control Trial  
Trial Acronym  TECARE 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Vinoth Gnana Chellaiyan Devanbu 
Designation  Professor 
Affiliation  Chettinad Hospital and Research Institute 
Address  Chettinad Hospital and research Institute OMR Kelambakkam Chennai

Chennai
TAMIL NADU
603103
India 
Phone  09944894554  
Fax    
Email  drchellaiyan@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Vinoth Gnana Chellaiyan Devanbu 
Designation  Professor 
Affiliation  Chettinad Hospital and Research Institute 
Address  Chettinad Hospital and Research Institute OMR Kelambakkam Chennai

Chennai
TAMIL NADU
603103
India 
Phone  09944894554  
Fax    
Email  drchellaiyan@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Vinoth Gnana Chellaiyan Devanbu 
Designation  Professor 
Affiliation  Chettinad Hospital and Research Institute 
Address  Chettinad Hospital and Research Institute OMR Kelambakkam Chennai

Chennai
TAMIL NADU
603103
India 
Phone  09944894554  
Fax    
Email  drchellaiyan@gmail.com  
 
Source of Monetary or Material Support  
Indian Council of Medical Research V. Ramalingaswami Bhawan, P.O. Box No. 4911. Ansari Nagar, New Delhi - 110029, India Ph: 91-11-26588895 
 
Primary Sponsor  
Name  ICMR 
Address  Indian Council of Medical Research. V. Ramalingaswami Bhawan, P.O. Box No. 4911. Ansari Nagar, New Delhi - 110029, 
Type of Sponsor  Government funding agency 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Vinoth G Chellaiyan  Chettinad Hospital and Research institute  Room no.7, Department of Community Medicine, A- Block, Chettinad Hospital & Research Institute, CHettinad Health City, OMR Kelambakkam Chennai-603103
Chennai
TAMIL NADU 
9944894554

drchellaiyan@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
CARE IHEC II  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: E089||Diabetes mellitus due to underlying condition without complications,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Regular follow up  Regular visit the diabetic clinic at regular intervals of 3 months and consultation  
Intervention  Telemedicine Support  Integrated Voice Response System and teleconsulation  
 
Inclusion Criteria  
Age From  30.00 Year(s)
Age To  65.00 Year(s)
Gender  Both 
Details  The inclusion criteria are as follows :
1. Age group between 30 to 65 years, both sexes.
2. Patients who have personal mobile phones
3. Patients who speak and understand either English/ Regional (Tamil) language
 
 
ExclusionCriteria 
Details  1. Pregnant and lactating women
2. Patients who are involved in any wellness programs
3. Patients with history of heart diseases
4. Patients with any orthopedic conditions that restrict physical activity
5. Patients with hearing difficulties such as hard of hearing
6. Patients with difficulties in vision
 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Participant and Investigator Blinded 
Primary Outcome  
Outcome  TimePoints 
The primary outcome measure of the study is decrease in HbA1c  The primary outcome will be measured at baseline,6 months, 9 months and at 12 months. 
 
Secondary Outcome  
Outcome  TimePoints 
. The secondary outcomes are adherence to the drug and medication advice, adherence to dietary advice, and adherence to physical activity advice.   at the end of 12th month 
 
Target Sample Size   Total Sample Size="200"
Sample Size from India="200" 
Final Enrollment numbers achieved (Total)= "200"
Final Enrollment numbers achieved (India)="200" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   01/04/2024 
Date of Study Completion (India) Date Missing 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) 30/06/2024 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Yet Recruiting 
Recruitment Status of Trial (India)  Completed 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - All of the individual participant data collected during the trial, after de-identification.

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Informed Consent Form
    Response - Clinical Study Report

  3. Who will be able to view these files?
    Response - Anyone

  4. For what types of analyses will this data be available?
    Response - Any purpose.

  5. By what mechanism will data be made available?
    Response - Data are available indefinitely at (Link to be included NIL).

  6. For how long will this data be available start date provided 01-01-2025 and end date provided 01-06-2025?
    Response - Immediately following publication. No end date.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - NIL
Brief Summary  


 

Summary of Background 

Problem Statement :

According to the International Diabetes Federation, the prevalence estimates of type 2 diabetes mellitus by 2040 will reach to 700 million from the current level of 463 million in 2019. Around three- fourths of this burden live in low and middle income countries including India.1-3 In India, the number of people with diabetes was 65 million with prevalence of 11.8% as per Ministry of Health and Family Welfare National Diabetes Survey report in 2019.4

 

With this high burden of disease in the country, it is very crucial in controlling the disease burden by continuous monitoring of disease and avoiding complication.5 However, the prevention and management of diabetes is largely influenced by individual behavior which can be achieved by extending the support beyond the clinic. This supportive role of patients by empowering individuals with information about the lifestyle and behaviors could be achieved by technology.6

Literature review

 

Following table provides an overview of studies conducted across the world which utilized technology as intervention.

 

Table 1 Literature review

 

Author

Country

Study design

Study population

Intervention

 

Results

Ramachandran et al9

India

Randomized controlled trial

Non diabetics

35-55 years

Mobile phone messages

18% developed T2DM in the

intervention group compared to 27%

in the controls

Pfammatter et al10

India

Cohort study

Non diabetics

Mobile phone messages

The intervention group reported an

improvement in diabetes risk behaviors,

specifically in fruit, vegetable, and fat

consumption

Faridi et al11

United states

Randomized controlled trial

Controlled diabetes population

Mobile phone messages

Improvement in HbA1c and

self‑efficacy

Wong et al12

China

Randomized controlled trial

Professional drivers who are pre-diabetics

Mobile phone messages

6% developed T2DM in the

intervention group compared to 16%

in the control group

Bin Abbos et al13

Saudi arabia

Non randomized trial

Diabetes patients

Mobile phone messages

The HbA1c decreased from 9.9% to

9.5%,

Present study

India

Randomized controlled trial

Diabetes patients

1.     Interactive voice response system

2.     Tele consultation

Multiple Expected outcomes :

I1.mprovement in HbA1c and other glycemic parameters

2.adherence to management practices

3.Cost effectiveness analysis

Bold font represents uniqueness and highlights of the study

 

 

 

Rationale of the study :

 

During March 2020, to provide equitable access to healthcare in India, NITI Aayog, Government of India, has published the telemedicine guidelines for the practice in India. In India, telemedicine practice for control and management of chronic diseases such as diabetes could help in coverage of services to larger geographical area, given the higher prevalence of diabetes in our country.7,8

The prevalence of diabetes in India is very high at around 12%. The country has three fourth of its population living in rural areas. Equitable access to healthcare in addition to adequate monitoring is the need of the hour to control the diabetes burden of the country. This gap can be filled by telemedicine practice. Implementing telemedicine in control and monitoring could keep diabetes morbidity in control and avoid progression to complications of diabetes.

The present study is an attempt to assess the impact of health education through technology on control of diabetes.

 

Novelty / Innovation :

1.Government of India in March 2020, has approved the practice of telemedicine in India and published guidelines to be followed. An RMP may proceed with his/her professional judgment to provide health promotion such as health education and counseling, as well as management of diseases. With this guidelines in place, the present study would assess the impact of such telemedicine practice for diabetes control in India.

 

2.Previous studies done across the globe using technology utilized short messaging services or software application based intervention, had limitations such as literacy status and lower ability to use the functions of the software application. The present study is planned in such a way that lack of certain factors such as reading and other skills should not interfere with the delivery of health education to patients with diabetes.

 

3. The present study involves dual service delivery- Interactive voice response system and video tele consultation for patients in intervention arm.

 

 

Hypothesis/ Research question 

 

1.     What is the impact of practice of telemedicine intervention on Diabetes control ?

2.     How effective is the telemedicine practice in controlling the diabetes and maintaining adherence to diabetes management practices ?

Study Objectives

The objectives of the study are

1. To evaluate the effect of intervention on Diabetes control with anthropometric

measures and biochemical parameters.

2. To assess the adherence to diabetes management practices such as adoption of adequate

physical activity, healthy dietary habits, drug compliance and quitting addiction habits.


 
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