Contact information
Type
Scientific
Primary contact
Prof Anne Williams
ORCID ID
Contact details
Nursing
Health and Social Care Research Centre
School of Nursing & Midwifery Studies
Eastgate House
35-43 Newport Road
Cardiff
CF24 0AB
United Kingdom
+44 (0)29 2091 7816
awglanrhyd@aol.com
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
0001653
Study information
Scientific title
Evidence into Practice: evaluating a Child-centred intervention for diabetes medicine management
Acronym
EPIC
Study hypothesis
Little evidence exists concerning the effectiveness of the types and formats of information that could empower children to make decisions regarding medicines and self-care. For children with type one diabetes, intensive structured education programmes exist, however there is insufficient evidence about the effectiveness of information underpinning these programmes or routine clinical management.
Aim:
To develop and evaluate an individually-tailored, age-appropriate information resource to support decision-making and self-care relating to insulin management and electronic blood glucose monitoring for children aged 6 - 18 years with type one diabetes, compared with available resources (if any) in routine clinical practice.
Objectives:
1. Review gold-standard clinical guidelines, currently available information including findings from completed Phase 1 of current SDO/145/2007 to identify best practice, and types/formats of information most likely to assist age-appropriate decision-making and choices concerning blood glucose monitoring and insulin management
2. Develop an age-appropriate child-centred information resource for children/young people, to support appropriate use of blood glucose meters to optimise management of and concordance with their insulin regime
3. Explore the utility of the resource within different contexts in which children manage their routine diabetes care (home, school, community) with and without support from parents or healthcare professionals, and in alternative settings
4. Explore how children with and without their parents, teachers, nurses, doctors use (or not) the information resource to support decision-making; in particular how children/parents 'self-prescribe' the correct (or incorrect) dose of insulin
5. Identify similarities and differences between the resource developed for adolescents and those available within adult diabetes services
6. Evaluate the resource within the context of routine diabetes care in relation to patient outcomes (diabetes-specific, health-related quality-of-life concordance, acceptability, ease of use, and glycaemic control)
7. Identify gaps in knowledge
Ethics approval
Ethics approval pending as of 12/06/2008.
Study design
Pragmatic randomised controlled trial
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Trial setting
Not specified
Trial type
Quality of life
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
Condition
Type one diabetes
Intervention
The investigation is a mixed-method study informed by the 'Promoting Action on Research Implementation in Health Services' (PARIHS) framework which has been widely used to inform design and evaluation of evidence-into-practice initiatives.
To meet our objectives which are aligned with the phases of the Medical Research Council (MRC) framework for randomised controlled trials (RCTs) of complex interventions we have designed a four-stage study:
Stage 1: Review and, where appropriate, undertake further work to identify types/formats of information most likely to assist age-appropriate decision-making/choices related to children/young people with type one diabetes. Duration: April 2008 to October 2008.
Stage 2: Construct an exemplar information resource, piloting for variations as necessary. Duration: November 2008 to October 2009.
Stage 3: Conduct a pragamatic evaluation to assess utility, acceptability effectiveness and cost effectiveness of the information resource. Duration: November 2009 to June 2010.
Stage 4: Undertake data synthesis and comparative analysis. Duration: July 2009 to March 2011.
The intervention lasts for 8 months with a follow-up at 3 months from baseline and 3 months from first follow-up.
Intervention type
Other
Phase
Not Specified
Drug names
Primary outcome measure
Choice of outcomes is guided by Health Technology Assessment (HTA) commissioned systematic reviews recommending that HbA1c (glycaemic control measure) is not the appropriate primary outcome on which to assess benefits of an intervention designed to more directly effect behaviour/self-management. Therefore, the primary outcome measure is diabetes self-efficacy and quality-of-life using the Diabetes Pediatric Quality of Life Inventory (PedsQol).
Outcomes will be measured at baseline, 3 months (follow-up 1) and 6 months (follow-up 2).
Secondary outcome measures
1. HbA1c
2. Generic quality of life
3. Routinely collected NHS/child-held data costs
4. Service use
5. Acceptability/utility
Outcomes will be measured at baseline, 3 months (follow-up 1) and 6 months (follow-up 2).
Overall trial start date
01/02/2009
Overall trial end date
01/09/2010
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. Children aged 6 - 18 years, either sex
2. Type one diabetes
Participant type
Patient
Age group
Child
Gender
Both
Target number of participants
200
Participant exclusion criteria
1. Severe learning difficulties
2. Significant social problems
3. Needle phobias
Recruitment start date
01/02/2009
Recruitment end date
01/09/2010
Locations
Countries of recruitment
United Kingdom
Trial participating centre
Nursing, Health and Social Care Research Centre
Cardiff
CF24 0AB
United Kingdom
Sponsor information
Organisation
Cardiff University (UK)
Sponsor details
7th Floor
30-36 Newport Road
Cardiff
CF24 0DE
United Kingdom
+44 (0)29 2087 5834
davieskp2@cf.ac.uk
Sponsor type
University/education
Website
Funders
Funder type
Government
Funder name
National Institute for Health Research (NIHR) (UK) - Service Delivery and Organisation (SDO) Programme (ref: 0001653)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)
Publication list
2010 protocol in http://www.ncbi.nlm.nih.gov/pubmed/20875112
2014 results in: http://www.ncbi.nlm.nih.gov/pubmed/25642573
Publication citations
-
Protocol
Noyes JP, Williams A, Allen D, Brocklehurst P, Carter C, Gregory JW, Jackson C, Lewis M, Lowes L, Russell IT, Rycroft-Malone J, Sharp J, Samuels M, Edwards RT, Whitaker R, Evidence into practice: evaluating a child-centred intervention for diabetes medicine management. The EPIC Project., BMC Pediatr, 2010, 10, 70, doi: 10.1186/1471-2431-10-70.
-
Results
Noyes JP, Lowes L, Whitaker R, Allen D, Carter C, Edwards RT, Rycroft-Malone J, Sharp J, Edwards D, Spencer LH, Sylvestre Y, Yeo ST, Gregory JW, Developing and evaluating a child-centred intervention for diabetes medicine management using mixed methods and a multicentre randomised controlled trial.