Older People With Type 2 Diabetes-Individualizing Management With a Specialized (OPTIMISE) Community Team: Protocol for a Safety and Feasibility Mixed Methods Study
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Neoh, Sandra
Aylen, Tracy
Audehm, Ralph
Churilov, Leonid
Thurgood, Lorenna
Major, Georgia
Zajac, Jeffrey
Ekinci, Elif
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Background: The prevalence of diabetes is rising in older people. In 2018, over 574,000 Australians reported having diabetes. The highest prevalence (19.4%) of diabetes has been observed in people aged 85 years and older. Clinical guidelines recommend that diabetes management should be individualized; however, there is limited information regarding the current management patterns of diabetes in older people, given most clinical trials exclude participants from this age group. Available data identify that few individuals achieve optimal glycemic levels in the general population, potentially leading to adverse health outcomes and impact on quality of life. The data on glycemic profiles of older population are limited. Objective: The aim of this study is to examine individualized diabetes management intervention for older people through home visits with a credentialed diabetes educator (CDE) and telehealth consultations with an endocrinologist located at a tertiary hospital. Methods: This paper describes the design and methodology of a mixed methods feasibility and safety study to identify the current management of type 2 diabetes in people aged 65 years or older. We will implement and evaluate a personalized approach to management in the community of an Australian metropolitan city. This management approach will utilize flash glucose monitoring and home visits with the support of a community home nursing service CDE and telehealth consultation with an endocrinologist located at a local tertiary hospital. Results: The study commenced in February 2017 and has recruited 43 participants, with final data collection to be completed by July 2019. Data analysis will commence after final data collection, with results expected to be published by the end of 2019. Conclusions: This study is the first of its kind to explore individualized diabetes management for community-dwelling older people, with an aim to achieve optimal glycemic levels (glycated hemoglobin between 53 and 69 mmol/mol [7%-8.5%] depending on the fitness and frailness of the older individual). The data drawn from this study may be used to inform policy makers, service providers, clinicians, and older adults living with diabetes.
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JMIR Research Protocols
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8
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6
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© Rajna Ogrin, Sandra Neoh, Tracy Aylen, Ralph Audehm, Leonid Churilov, Lorenna Thurgood, Georgia Major, Jeffrey Zajac, Elif I Ekinci. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 07.06.2019. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.
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Clinical sciences
Public health
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Public, Environmental & Occupational Health
type 2 diabetes mellitus
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Ogrin, R; Neoh, S; Aylen, T; Audehm, R; Churilov, L; Thurgood, L; Major, G; Zajac, J; Ekinci, E, Older People With Type 2 Diabetes-Individualizing Management With a Specialized (OPTIMISE) Community Team: Protocol for a Safety and Feasibility Mixed Methods Study, JMIR Research Protocols, 2019, 8 (6), pp. e13986