Continuous care program in primary care to improve type 2 diabetes control in Terres de l'Ebre

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a cluster-randomized, parallel-group intervention where primary care centers in the Terres de l'Ebre region are assigned to either a continuity-of-care program or usual care. The intervention delivers structured, multidisciplinary training and audit-and-feedback from endocrinologists and nurse educators to all primary care professionals at intervention centers over one year (July 2025–July 2026). Eligible adult patients with at least 12 months of documented T2DM in the eCAP electronic health record are followed with outcomes measured at baseline, 6, 12, and 24 months. The control arm continues routine primary care management while the intervention arm implements the training modules and feedback loops.

Why it matters

Who can join: the full rules

Inclusion Criteria:

Enrollment will begin in July 2025, aligned with the initiation of training sessions for healthcare professionals (physicians and nurses).

Eligible participants must:

* Be adults (≥18 years old)
* Have an active diagnosis of T2DM documented in the eCAP primary care electronic health record system
* Have a duration of T2DM of at least 12 months as of January 2025

Exclusion Criteria:

* Diagnosis of type 1 diabetes mellitus (T1DM)
* T2DM managed by a specialist at the time of inclusion
* Current treatment with systemic corticosteroids
* Active neoplasia (malignancy)
* Gestational diabetes
* Pregnancy or breastfeeding
* Diagnosis of MACA (advanced chronic disease with life expectancy \<1 year)
* Complex chronic patients (CCP)
* Diagnosis of dementia
* Institutionalized patients or those residing in social healthcare facilities
* Age over 90 years
* Age under 18 years
* Severe psychiatric illness (e.g., psychosis, bipolar disorder, major depression)
* History of kidney transplant
* Undergoing dialysis
* History of alcohol or drug abuse

Where it's running

• Abs Amposta
  Amposta, Tarragona, Spain Recruiting
• Abs Deltebre
  Deltebre, Tarragona, Spain Recruiting
• Abs Ametlla-Perelló
  El Perelló, Tarragona, Spain Recruiting
• Abs Flix
  Flix, Tarragona, Spain Recruiting
• Abs Gandesa
  Gandesa, Tarragona, Spain Recruiting
• Abs Ampolla-Aldea
  L'Ampolla, Tarragona, Spain Recruiting

Study contacts

• Principal investigator: Marcela Miret Llauradó, MD — Catalan Institute of Health
• Study coordinator: Marcela Miret Llauradó, MD
• Email: mmiretl.ebre.ics@gencat.cat
• Phone: +0034977519100

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.