Allen 2011.
Study characteristics | ||
Methods |
COACH Trial: a randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centres Patient RCT (NA clusters and NA providers), recruited from 2 community health centres (part of Baltimore Medical Systems Incorporated ‐ BMS, a federally qualified community health centre). In USA. 2 arms: (control arm) (intervention arm) |
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Participants | Control arm N: 264 Intervention arm N: 261, NA, NA Diabetes type: 2 Mean age: NR ± NR % Male: NR Longest follow‐up: 12 months |
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Interventions |
Control arm: (enhanced usual care (EUC)) 1) Clinician education 2) Clinician reminder 3) Patient education 4) Patient reminder Intervention arm: (Nurse Practitioner/Community Health Worker (NP/CHW)) 1) Case management 2) Team change 3) Patient education 4) Promotion of self‐management |
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Outcomes | 1) Glycated haemoglobin 2) Systolic blood pressure 3) Diastolic blood pressure 4) Low‐density lipoprotein |
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Funding source | This study was supported by the National Heart Lung and Blood Institute, National Institutes of Health grant # R01HL082638 | |
Notes | — | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Not described: "…participants were randomly assigned." |
Allocation concealment (selection bias) | Unclear risk | Not described: "…participants were randomly assigned." |
Patient's baseline characteristics (selection bias) | Low risk | In table and text. Quote: "There were no significant differences in sociodemographic and baseline measures between the two groups except for higher total cholesterol and HbA1c levels in the NP/CHW intervention group compared to the EUC." |
Patient's baseline outcomes (selection bias) | High risk | HbA1c (P = 0.006). |
Incomplete outcome data (attrition bias) | Low risk | Intention‐to‐treat analysis with imputations, non‐significant differences in attrition rates, number and reasons for loss to follow‐up provided. Baseline based on those randomised. |
Blinding of participants and personnel (performance bias) and of outcome assessors (detection bias) | Low risk | Primary: lipids, blood pressure, HbA1c. LDL measured using Friedewald equation. HbA1c measured using liquid chromatography. Blood pressure using Omron digital blood pressure monitor. Blinding not described. |
Selective reporting (reporting bias) | High risk | Some primary outcomes listed in protocol were not reported in the manuscript: physical activity, smoking cessation, antiplatelet use, beta blockers use, ACE inhibitors use. |
Risk of contamination (other bias) | High risk | Quote: "…physicians had patients in both the intervention and the EUC groups. This may have resulted in a change in the level of care provided to their patients in the EUC groups…" |
Other bias | Low risk | Information not available. |