Improving diabetes care: multi-component cardiovascular disease risk reduction strategies for people with diabetes in South Asia--the CARRS multi-center translation trial.
OBJECTIVE
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in people with diabetes in South Asia. The CARRS Translation Trial tests the effectiveness, cost-effectiveness, and sustainability of a clinic-based multi-component CVD risk reduction intervention among people with diabetes in India and Pakistan.


METHODS
We randomly assigned 1146 adults with diabetes recruited from 10 urban clinic sites, to receive usual care by physicians or to receive an integrated multi-component CVD risk reduction intervention. The intervention involves electronic health record management, decision-support prompts to the healthcare team, and the support of a care coordinator to actively facilitate patient and provider adherence to evidence-based guidelines. The primary outcome is a composite of multiple CVD risk factor control (blood glucose and either blood pressure or cholesterol, or all three). Other outcomes include control of the individual CVD risk factors, process and patient-centered measures, cost-effectiveness, and acceptability/feasibility.


CONCLUSIONS
The CARRS Translation Trial tests a low-cost diabetes care delivery model in urban South Asia to achieve comprehensive cardio-metabolic disease case-management of high-risk patients (clinicaltrials.gov number: NCT01212328).
Emory University, Rollins School of Public Health, Atlanta, GA 30322, USA.
Seema
S
Shah
Kavita
K
Singh
Mohammed K
MK
Ali
V
V
Mohan
Muhammad Masood
MM
Kadir
A G
AG
Unnikrishnan
Rakesh Kumar
RK
Sahay
Premlata
P
Varthakavi
Mala
M
Dharmalingam
Vijay
V
Viswanathan
Qamar
Q
Masood
Ganapathi
G
Bantwal
Rajesh
R
Khadgawat
Ankush
A
Desai
Bipin Kumar
BK
Sethi
Roopa
R
Shivashankar
Vamadevan S
VS
Ajay
K Srinath
KS
Reddy
K M Venkat
KM
Narayan
Dorairaj
D
Prabhakaran
Nikhil
N
Tandon
D000328:Adult; D001208:Asia; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2; D006801:Humans; D040242:Risk Reduction Behavior; D012984:Software