Diabetes Outreach Van Enhancement Study (DOVE)
The Diabetes Outreach Van Enhancement (DOVE) Study started early in April 2000. The purpose of this project is to determine whether the care for patients with type 2 diabetes in Northern Alberta can be improved through a diabetes outreach service. Keeweetinok Lakes and Peace Regional Health Authorities (RHA) were targeted for this study as they are similar in size, population, health care resources, and Aboriginal population.
The diabetes outreach service made six visits to the Peace River RHA over the summer of 2000 and travelled to the Keeweetinok Lakes area six times in the summer/fall of 2001. A cohort of 393 patients with diabetes was enrolled and followed from these regions to determine the impact of this intervention. The initial 6-month follow-up was completed in 2001, and a longer term, 18-month follow-up was completed in 2002.
The DOVE Study established the feasibility of the intervention, measurement tools, budget, and timelines. Furthermore, the intervention was well received by the local care providers. The diabetes outreach service was an attempt to bridge the gap between what has been recommended and what is achievable in rural communities. The initial short term results indicate that this intervention is useful, feasible, and affordable, it could serve as a model for improving diabetes care in under-served rural communities. We are now conducting the evaluation of the 18-month follow-up to determine if the initial improvements quality of care were sustained.
Ellen Toth, Jeff Johnson, Sumit Majumdar, Richard Lewanczuk, TK Lee, Lisa Guirguis, Dean Eurich
Institute of Health Economics
Canadian Diabetes Association
Caritas Health Group
Majumdar SR, Johnson JA, Guirguis LM, Lewanczuk RZ, Lee TK, Toth EL. Rationale and Design for the DOVE Study: A Prospective Controlled Trial of an Intervention to Improve Care for Patients with Diabetes in Rural Communities. Canadian Journal of Diabetes Care 2001;25(3):173-179
Toth EL, Majumdar SR, Guirguis LM, Lewanczuk RZ, Lee TK, Johnson JA. Under treatment of cardiovascular risk factors in rural patients with type 2 diabetes. Pharmacotherapy 2003;23:659-665.
Majumdar SR, Guirguis LM, Toth EL, Lewanczuk RZ, Lee TK, Johnson JA. Controlled trial of a multifaceted intervention for improving quality of care for rural patients with type 2 diabetes. Diabetes Care 2003;26:3061-3066.
Maddigan SL, Majumdar SR, Guirguis LM, Lewanczuk RZ, Lee TK, Toth EL, Johnson JA. Improvements in Patient-Reported Outcomes with an Intervention to Enhance Quality of Care for Rural Patients with Type 2 Diabetes: Results of a Controlled Trial. Diabetes Care 2004;27:1306-1312.
Johnson JA, Eurich DT, Toth EL, Lewanczuk RZ, Lee TK, Majumdar SR. Generalizability and persistence of a multifaceted intervention for improving quality of care for rural patients with type 2 diabetes. Diabetes Care 2005;28:783-788.
Ralph-Campbell K, Maddigan SL, Guirguis LM, Toth EL for the DOVE Investigators. Aboriginal Participation in the DOVE Study. Canadian Journal of Public Health 2006;97(4):305-9.