ACHORD’s research is focused on diabetes and its comorbidities and complications, particularly cardiovascular and kidney diseases. Our research can be broken down into clinical epidemiology, economic and health-related quality of life of diabetes. Our aim is to provide research which will lead to improved management of diabetes in Canada, from both clinical and health policy perspectives.
The Alberta's Caring for Diabetes (ABCD) project, funded by Alberta Health, was developed to improve the quality and efficiency of care for diabetes in Alberta, with a focus on supporting primary care outside of the metro Edmonton and Calgary areas. The ABCD project involves a large cohort study, the Diabetes Complications Study, two main quality improvement interventions: 1) Depression screening and collaborative care management for diabetes patients (TeamCare-PCN) and 2) Lifestyle behavioral support intervention called Healthy Eating and Active Living in Diabetes (HEALD-PCN), as well as other projects [APEXD, PROACTIVE, Accelerometer sub-study]. Research and evaluation of these interventions will contribute to a number of other studies lead by ACHORD researchers to determine and influence factors that lead to better quality of care and improved health outcomes for people with diabetes.
ABCD Project Design and Recruitment
The ABCD project is proud to collaborate with local Primary Care Networks throughout Alberta. A Primary Care Network (PCN) is a group of family doctors and other health professionals working together with Alberta Health Services to coordinate primary health services for patients. PCNs take a comprehensive approach to health management, emphasizing health promotion, disease and injury prevention, and the care of patients with medically complex problems and chronic diseases. As such, PCNs are an ideal environment for the implementation and evaluation of the ABCD project.
For more information about PCN's, visit www.albertapci.ca
Jenna Shmyr, Kinesiologist, St. Alberta and Sturgeon Primary Care Network, works with participants of the Healthy Eating and Active Living for Diabetes (HEALD) project.
For more information about the ABCD interventions and other quality of care studies, link to:
The Alberta Diabetes Surveillance System (ADSS) provides an overall picture of the burden of diabetes in the province and a system to monitor trends of diabetes and its complications over time. The system tracks the number of people living with diabetes in Alberta, their related health conditions, and the health services they use. This information helps health care providers and policy makers understand the scope of the disease and how to deal with it. The ADSS is a partnership between the Institute of Health Economics, ACHORD and Alberta Health and Wellness. To support the ADSS, ACHORD also undertakes methodological studies to improve these surveillance systems using administrative data sources.
The relationship between cancer and diabetes has becoming increasingly recognized in recent years. These two conditions have common risk factors, including obesity, unhealthy diet and physical inactivity. The ACHORD Group is exploring the relationship between diabetes and cancer and the role that glucose-lowering therapies might have in modulating this relationship.
Cardiovascular disease is the leading cause of morbidity and mortality in people with diabetes. It has therefore been a major focus of our research in the ACHORD Group. In particular, we have been interested in the association between diabetes, various glucose lowering therapies and cardiovascular outcomes. We have also conducted intervention studies to improve the quality of care for type 2 diabetes in primary care settings, with a particular focus on improving the management of cardiovascular risk factors, such as blood pressure and lipid management.
The interaction between mental health and chronic diseases like diabetes has been an important area of focus for the ACHORD group. We have research projects evaluating the relationship between diabetes and schizophrenia, as well as diabetes and depression.
Whereas strong evidence supports the role of lifestyle modification in the prevention and management of T2D, we lack a clear understanding of best strategies for dietary and physical activity behaviour promotion among adults with T2D within primary care. Current clinical practice guidelines are based on resource laden, one-to-one individual and clinically-based approaches to lifestyle modification, with limited theoretical grounding for recommended health behaviour change. Furthermore, numerous barriers exist for the primary care physicians to direct counselling for lifestyle modification. Consequently, little guidance is available for practical, sustainable, economically viable solutions, with limited evidence of long-term efficacy and efficiency.
An important theme area for ACHORD is economic and policy oriented research. Using a variety of methods, including analysis of large provincial health care administrative databases, economic evaluations and controlled trials, we are addressing questions about the economic burden of diabetes, and how we can more efficiently allocate our limited resources within the health care system.
ACHORD Group has expertise in measurement of patient-reported outcomes, including health-related quality of life and patient satisfaction. Patient reported outcomes are becoming increasingly important in the assessments of population health and quality improvement interventions.