Identifying and Overcoming Barriers to Diabetes Management in the Elderly: A Cost-effective Intervention Study (DISCO)

Joslin Diabetes Center

Status: Completed

Conditions: Diabetes

Treatments: Behavioral: Behavioral

Study type: Interventional

Funder types: Other

Identifiers

NCT01486290

07-03

Details and patient eligibility

About

The purpose of this study is to find ways to identify barriers that affect self care in older adult with diabetes and to provide cost effective coping strategies to improve clinical, functional and psychosocial measures.

Full description

This is a study to evaluate whether short term focused intervention by a geriatric diabetes team to help overcome barriers to diabetes care in older adults will result in improved clinical, functional, and quality of life measures compared to usual care in a cost effective manner. In addition, we will assess whether the support network formed during intervention by the geriatric diabetes team will empower patients, resulting in long lasting improvement in parameters after intervention is completed.

Enrollment: 52 patients

Sex: All

Ages: 69+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 70 years and older
• Diagnosis of type 1 or type 2 diabetes
• Seen at Joslin Clinic or Beth Israel Deaconess Medical Center for at least one year
• HbA1c 8% X 2 in past 6 months without fluctuation of more than 0.5% (i.e. stable poor control)
• No major change in medications in past 3 months, e.g. addition of insulin or another hypoglycemic agent

Exclusion criteria

• Patients with terminal diseases, e.g. malignancy with expected life expectancy of 12 months or less
• Patients who live more than 25 miles from Joslin Clinic/Beth Israel Deaconess Medical Center
• Patients who live in an institutional setting (e.g. nursing home, group home, etc)
• Patients who are not able to complete outcome assessments, (e.g. poor vision, diminished mental capacity/severe cognitive decline, unable to speak/read/write English

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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52 participants in 2 patient groups

Geriatric Diabetes Team Intervention

Experimental group

Description:

The subjects in this group underwent evaluation for barriers to self care by a diabetes educator well versed with age specific barriers. After consideration of patient clinical, function, and psychosocial background, a geriatric diabetes team devised strategy to help patients cope with respective barriers. An office based diabetes diabetes educator conveyed the strategy to patient and caregivers viz phone calls. the educator called study participants up wot eleven times over a sex month period.

Treatment:

Behavioral: Behavioral

Atention Control Arm

No Intervention group

Description:

The subjects in the group received similar, in person contact, as the intervention group. an educator, separate from the one involved in the intervention team, called patients in this group for a total of eleven times within the first six months. The Phone calls were focused toward general discussion without any diabetes related advice.