Evidence map›Paper›PMID 29178317›Full record

Trial reportJournal of the American Geriatrics Society2018

Community Program Improves Quality of Life and Self-Management in Older Adults with Diabetes Mellitus and Comorbidity.

Maureen Markle-Reid, Jenny Ploeg, Kimberly D Fraser, Kathryn A Fisher, Amy Bartholomew, Lauren E Griffith, John Miklavcic, Amiram Gafni, Lehana Thabane, Ross Upshur

Registry-linked trialOpen access · hybridAbstract readPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Geriatrics Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02158741 (A Client-Driven Intervention to Support Self-Management Among Community-Living Older Adults With Type 2 Diabetes and Multiple Chronic Conditions), which is not on this map. Cited by 75 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed, 7 pooled it
7.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02158741 nacompletednot on this map

A Client-Driven Intervention to Support Self-Management Among Community-Living Older Adults With Type 2 Diabetes and Multiple Chronic Conditions

TypeinterventionalSponsorMcMaster UniversityRan2014 to 2017Enrolled291ConditionsType 2 Diabetes Mellitus, NIDDM, Non-insulin Dependent Diabetes MellitusArmsHome Visits and Lifestyle Education Support
3 · Its place in the literature

Who cites it

75 citing papers in PubMed, 7 syntheses or guidelines pooled it, 170 citations in OpenAlex.

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  3. Influence of health-system change on treatment burden: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
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  7. Diabetes-Specific Dementia: A Structured Literature Review of Cognitive Assessment Methods.The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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15 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Maureen Markle-ReidAging Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Jenny PloegAging Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Kimberly D FraserFaculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Kathryn A FisherAging Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Amy BartholomewAging Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Lauren E GriffithDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
John MiklavcicFaculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Amiram GafniDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Lehana ThabaneDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Ross UpshurDivision of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
McMaster University · CAImpact · CAUniversity of Alberta · CAHamilton Health Sciences · CAPublic Health Ontario · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo compare the effect of a 6-month community-based intervention with that of usual care on quality of life, depressive symptoms, anxiety, self-efficacy, self-management, and healthcare costs in older adults with type 2 diabetes mellitus (T2DM) and 2 or more comorbidities.

designMultisite, single-blind, parallel, pragmatic, randomized controlled trial.

settingFour communities in Ontario, Canada.

participantsCommunity-dwelling older adults (≥65) with T2DM and 2 or more comorbidities randomized into intervention (n = 80) and control (n = 79) groups (N = 159).

interventionClient-driven, customized self-management program with up to 3 in-home visits from a registered nurse or registered dietitian, a monthly group wellness program, monthly provider team case conferences, and care coordination and system navigation. MEASUREMENTS: Quality-of-life measures included the Physical Component Summary (PCS, primary outcome) and Mental Component Summary (MCS, secondary outcome) scores of the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12). Other secondary outcome measures were the Generalized Anxiety Disorder Scale, Center for Epidemiologic Studies Depression Scale (CES-D-10), Summary of Diabetes Self-Care Activities (SDSCA), Self-Efficacy for Managing Chronic Disease, and healthcare costs.

resultsMorbidity burden was high (average of eight comorbidities). Intention-to-treat analyses using analysis of covariance showed a group difference favoring the intervention for the MCS (mean difference = 2.68, 95% confidence interval (CI) = 0.28-5.09, P = .03), SDSCA (mean difference = 3.79, 95% CI = 1.02-6.56, P = .01), and CES-D-10 (mean difference = -1.45, 95% CI = -0.13 to -2.76, P = .03). No group differences were seen in PCS score, anxiety, self-efficacy, or total healthcare costs.

conclusionParticipation in a 6-month community-based intervention improved quality of life and self-management and reduced depressive symptoms in older adults with T2DM and comorbidity without increasing total healthcare costs.

Indexed as

ComorbidityQuality of LifeAgedDiabetes Mellitus, Type 2FemaleHealth Care CostsHumansMaleOntarioSelf-ManagementSingle-Blind Methodcommunity-based programcomorbidityolder adultsself-managementtype 2 diabetes mellitus

Identifiers

PMID29178317
PMCPMC5836873
OpenAlexW2768185613

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.