Community Paramedicine Program to Improve Diabetes Management Among Adults Experiencing Severe Hypoglycemia
试验速览
- 阶段
- 不适用
- 状态
- 暂停
- 发起方
- Mayo Clinic
- 入组人数
- 150
- 试验地点
- 2
- 主要终点
- Diabetes Self-Management
研究概览
简要总结
This pilot study will assess the feasibility, preliminary efficacy, and acceptability of the Diabetes-REM (Rescue, Engagement, and Management), a comprehensive patient-centered intervention delivered by community paramedics in the community setting to improve diabetes self-management, prevent recurrent hypoglycemia, reduce diabetes distress, and improve quality of life among adults in southeast Minnesota who have experienced severe hypoglycemia.
详细描述
Severe hypoglycemia in the management of diabetes is associated with high morbidity, mortality, psychological distress, and impaired quality of life. Recognizing, actively engaging, and providing comprehensive care to at-risk patients to address hypoglycemia risk factors and enhance diabetes self-management skills may help reduce the frequency/severity of hypoglycemic events, alleviate diabetes distress, and improve quality of life.
This study will assess the feasibility, preliminary efficacy, and acceptability of Diabetes-REM (Rescue, Engagement, and Management) to improve diabetes self-management among adults in southeast Minnesota who have experienced severe hypoglycemia. The D-REM program is a one month long intervention delivered by community paramedics at the patient's home. Community paramedics are trained in disease prevention, management, and wellness in addition to emergency response.
Using a two-group parallel design, 150 adults will be randomly assigned to 1 month of Diabetes-REM or usual care. Both groups will receive education materials on hypoglycemia/diabetes and clinical/community resources. One group, comprised of 75 patients, will also be cared for by community paramedics at no cost to them. Study measures will include surveys (completed by participants in both arms) and an interview (completed by a subset of participants in the arm receiving community paramedic support).
Eligible individuals who decline participation in the D-REM trial will then be offered participation in a one-time interview conducted via audio technology to understand their experiences with hypoglycemia and its prevention.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults 18 years of age or older.
- •Experience of level 3 hypoglycemia
- •Type 1 or type 2 diabetes.
- •Paneled to a Mayo Clinic or Mayo Clinic Health System practice.
- •Able to provide informed consent.
- •Community-dwelling in either Freeborn, Mower, Olmsted, Steele, or Wabasha county.
- •Identifying patients who experienced level 3 hypoglycemia:
- •Treated by Mayo Clinic Ambulance for hypoglycemia
- •Treated in Mayo Clinic ED or hospital for hypoglycemia.
- •Patients who have a diagnosis of hypoglycemia on their electronic health record problem list.
- •Patients who experienced level 3 hypoglycemia and are referred to the community paramedic service by their healthcare provider.
排除标准
- •Under 18 years of age.
- •Cognitive impairment precluding informed consent.
- •Lack of conversational English skills.
- •Residency in a long-term care facility.
- •Enrolled in hospice.
- •Enrolled in a care coordination or disease management program.
- •Advanced or terminal illness.
研究组 & 干预措施
Community Paramedic (CP) program and Education Materials
Subjects will receive CP home visits and telephone calls for 1 month, along with printed diabetes education materials and a resource guide for contacting their diabetes care team in addition to usual care.
干预措施: Community Paramedic Program (Other)
Community Paramedic (CP) program and Education Materials
Subjects will receive CP home visits and telephone calls for 1 month, along with printed diabetes education materials and a resource guide for contacting their diabetes care team in addition to usual care.
干预措施: Education Material (Other)
Usual Care and Education Materials
Subjects will receive printed diabetes education materials and a resource guide for contacting their diabetes care team in addition to usual care.
干预措施: Education Material (Other)
结局指标
主要结局
Diabetes Self-Management
时间窗: Baseline, 1 month, 4 months
Change in Diabetes Self-Management Questionnaire (DSMQ) score
次要结局
- Diabetes distress(Baseline, 1 month, 4 months)
- Glycemic control(Baseline, 4 months)
- Self-reported hypoglycemia(Baseline, 1 month, 4 months)
- Health-related Quality of life (EQ-5D)(Baseline, 1 month, 4 months)
- Qualitative experience with hypoglycemia and its prevention(Baseline (one-time interview only))
研究者
Rozalina G. McCoy
Principal Investigator
Mayo Clinic