scholarly journals Continuous glucose monitoring in older people with diabetes receiving home care—a feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Assessment Tool ◽  
Glucose Monitoring ◽  
Cognitive Status ◽  
Ease Of Use ◽  
Quality Of Data ◽  
Care Services

Abstract Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities, and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home-dwelling individuals with diabetes type 2 receiving home care. Methods CGM with the Ipro2-blinded monitoring system were performed for 5 days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c)) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)), and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home. Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent, and ease of use. The MMSE survey required extensive training of personnel to be conducted. Conclusion The feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home-dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used “as is” for future studies.

scholarly journals Continuous glucose monitoring in older people with diabetes receiving home care - A feasibility study

2020 ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Assessment Tool ◽  
Glucose Monitoring ◽  
Cognitive Status ◽  
Ease Of Use ◽  
Quality Of Data ◽  
Care Services

Abstract BackgroundHypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home dwelling individuals with diabetes type 2 receiving home care.MethodsCGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home.ResultsThe practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted.ConclusionThe feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.

scholarly journals Continuous glucose monitoring in older people with diabetes receiving home care - A feasibility study

2020 ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Assessment Tool ◽  
Glucose Monitoring ◽  
Cognitive Status ◽  
Ease Of Use ◽  
Quality Of Data ◽  
Care Services

Abstract Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home dwelling individuals with diabetes type 2 receiving home care. Methods CGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home. Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted. Conclusion The feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals. We will ascertain that personnel who will use the MMSE questionnaire to collect cognitive status and skills are familiar with the tool and adequately educated and trained before study start. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.

scholarly journals Continuous glucose monitoring in older people with diabetes receiving home care - A feasibility study. 

2020 ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Feasibility Study ◽  
Assessment Tool ◽  
Glucose Monitoring ◽  
Ease Of Use ◽  
Quality Of Data ◽  
Care Services

Abstract Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidences of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to examine the feasibility of capturing hypoglycemia and issues associated with increased risk of hypoglycemia by use of continuous glucose monitoring (CGM) and standardized questionnaires among older home dwelling individuals with diabetes type 2 receiving home care. MethodsCGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data was collected by a study nurse in the individuals’ home. Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted. ConclusionThe feasibility study informs an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals, where we will reconsider the use of the MMSE questionnaire. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.

scholarly journals Hypoglycemia in older people with diabetes receiving home care: A feasibility-study

2020 ◽  
Author(s):  
Annette Bævre Larsen ◽  
Monica Hermann ◽  
Marit Graue
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Older People ◽  
Feasibility Study ◽  
Assessment Tool ◽  
Ease Of Use ◽  
Risk Assessment Tool ◽  
Quality Of Data ◽  
Care Services

Abstract Background Hypoglycemic incidents in older people can cause severe health problems, enhance general age-related disabilities and cause frailty. Little is known about incidence of hypoglycemia in older home-dwelling people with diabetes. Thus, the aim of this study was to investigate the feasibility of using continuous glucose monitoring (CGM) and standardized questionnaires on issues associated with increased risk of hypoglycemia among older home dwelling individuals with diabetes type 2 receiving home care. Methods CGM with the Ipro2 blinded monitoring system were performed for five days in six home-dwelling individuals ≥ 75 years diagnosed with diabetes and receiving home care. Demographic (age, gender, living arrangements) and clinical data (diabetes diagnoses and duration, diabetes medication, documented treatment goal, available glycosylated hemoglobin (HbA1c),) were collected from electronic patient records in home care services. Feasibility (ease of use, quality of data, time spent) of standardized questionnaires to identify the risk of hypoglycemia (the McKellar Risk Assessment Tool), risk of malnutrition (the Mini Nutritional Assessment (MNA)), functional status (the Individual-based Statistics for Nursing and Care Services (IPLOS)) and cognitive status (the Mini Mental Status Exam (MMSE)) was also assessed. Questionnaire data were collected by a study nurse in the individuals’ home.Results The practical use of CGM was satisfactory, with no major remarks about discomfort or technical errors, except for one participant with skin reaction (redness). Collecting data with the McKellar Risk Assessment Tool, MNA and IPLOS worked well according to quality of data, time spent and ease of use. The MMSE survey required extensive training of personnel to be conducted. Conclusion The feasibility study inform an upcoming study on the incidence and risk factors of hypoglycemia in home dwelling older individuals, were we will reconsider the use of the MMSE questionnaire. The use of blinded CGM in this population was well tolerated and can be used ‘as is’ for future studies.

scholarly journals Using the Multidimensional Prognostic Index to Predict Clinical Outcomes of Hospitalized Older Persons: A Prospective, Multicenter, International Study

2018 ◽  
Vol 74 (10) ◽  
pp. 1643-1649 ◽  
Author(s):  
Alberto Pilotto ◽  
Nicola Veronese ◽  
Julia Daragjati ◽  
Alfonso J Cruz-Jentoft ◽  
Maria Cristina Polidori ◽  
...  
Keyword(s):  
Home Care ◽  
Older Patients ◽  
Risk Group ◽  
Prognostic Index ◽  
Home Care Services ◽  
Cognitive Status ◽  
Public Hospitals ◽  
Mortality Data ◽  
Care Services ◽  
Overall Mortality

Abstract Background Multidimensional Prognostic Index (MPI) is useful as a prognostic tool in hospitalized older patients, but our knowledge is derived from retrospective studies. We therefore aimed to evaluate in a multicenter, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, rehospitalization, and use of home care services during 12 months. Methods This longitudinal study, carried out between February 2015 and August 2017, included nine public hospitals in Europe and Australia. A standardized comprehensive geriatric assessment including information on functional, nutritional, cognitive status, risk of pressure sores, comorbidities, medications, and cohabitation status was used to calculate the MPI and to categorize participants in low, moderate, and severe risk of mortality. Data regarding mortality, institutionalization, rehospitalization, and use of home care services were recorded through administrative information. Results Altogether, 1,140 hospitalized patients (mean age 84.1 years, women = 60.8%) were included. In the multivariable analysis, compared to patients with low risk group at admission, patients in moderate (odds ratio [OR] = 3.32; 95% CI: 1.79–6.17; p < .001) and severe risk (OR = 10.72, 95% CI: 5.70–20.18, p < .0001) groups were at higher risk of overall mortality. Among the 984 older patients with follow-up data available, those in the severe-risk group experienced a higher risk of overall mortality, institutionalization, rehospitalization, and access to home care services. Conclusions In this cohort of hospitalized older adults, higher MPI values are associated with higher mortality and other negative outcomes. Multidimensional assessment of older people admitted to hospital may facilitate appropriate clinical and postdischarge management.

scholarly journals A Causal Relationship of Home Care Services on the Quality of Life among Survivors of Stroke in Thailand

2021 ◽  
Vol 18 (5) ◽  
Author(s):  
Patoomthip ADUNWATANASIRI ◽  
Siriorn SINDHU ◽  
Napaporn WANITKUN ◽  
Chukiat VIWATWONGKASEM
Keyword(s):  
Quality Of Life ◽  
Home Care ◽  
Functional Status ◽  
Home Care Services ◽  
Self Management ◽  
Stroke Survivors ◽  
Management Support ◽  
Policy Makers ◽  
Care Services

Survivors of stroke suffer impairments associated with a complex need of care from healthcare services after being discharged from hospital and returning home, and these impairments affect the quality of their lives. This cross-sectional study, aimed at evaluating the pathways linking home care services, patient factors, and quality of life (QOL), was carried out by conducting interviews and questionnaires with stroke survivors at their homes. Simple random sampling was used to select the settings for data collection, and multi-stage sampling was used to select the samples. In all, 317 stroke survivors admitted to 13 hospitals in rural and urban setting were selected for participation in the study. The data obtained were analyzed by using Structural Equation Modeling (SEM). The hypothetical model demonstrated a good fit (chi-square = 15.299, df = 9, p = 0.083, GFI = 0.98, CFI = 0.98, RMSEA = 0.047). Statistically significant explanatory variables for the home care service had a direct effect on perceived self-management support, functional status, and QOL (β = 0.39, 0.12 and 0.11, respectively), while number of community supporters had a significant positive indirect effect on QOL through functional status (β = 0.13). The variables accounted for 56 % of the variance in QOL. This finding could be used by policy makers to make important policy development in home care services and help improve health outcomes. In particular, it is also recommended that policy makers push for policies that encompass self-management support and community support groups among stroke survivors in community settings.

scholarly journals Interprofessional Stroke Rehabilitation for Stroke Survivors Using Home Care

2011 ◽  
Vol 38 (2) ◽  
pp. 317-334 ◽  
Author(s):  
Maureen Markle-Reid ◽  
Camille Orridge ◽  
Robin Weir ◽  
Gina Browne ◽  
Amiram Gafni ◽  
...  
Keyword(s):  
Home Care ◽  
Stroke Rehabilitation ◽  
Intervention Group ◽  
Home Care Services ◽  
Stroke Survivors ◽  
Interprofessional Team ◽  
Care Services ◽  
Sf 36

Objective:To compare a specialized interprofessional team approach to community-based stroke rehabilitation with usual home care for stroke survivors using home care services.Methods:Randomized controlled trial of 101 community-living stroke survivors (<18 months post-stroke) using home care services. Subjects were randomized to intervention (n=52) or control (n=49) groups. The intervention was a 12-month specialized, evidence-based rehabilitation strategy involving an interprofessional team. The primary outcome was change in health-related quality of life and functioning (SF-36) from baseline to 12 months. Secondary outcomes were number of strokes during the 12-month follow-up, and changes in community reintegration (RNLI), perceived social support (PRQ85-Part 2), anxiety and depressive symptoms (Kessler-10), cognitive function (SPMSQ), and costs of use of health services from baseline to 12 months.Results:A total of 82 subjects completed the 12-month follow-up. Compared with the usual care group, stroke survivors in the intervention group showed clinically important (although not statistically significant) greater improvements from baseline in mean SF-36 physical functioning score (5.87, 95% CI -3.98 to 15.7; p=0.24) and social functioning score (9.03, CI-7.50 to 25.6; p=0.28). The groups did not differ for any of the secondary effectiveness outcomes. There was a higher total per-person costs of use of health services in the intervention group compared to usual home care although the difference was not statistically significant (p = 0.76).Conclusions:A 12-month specialized, interprofessional team is a feasible and acceptable approach to community-based stroke rehabilitation that produced greater improvements in quality of life compared to usual home care. Clinicaltrials.gov identifier: NCT00463229

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