Evidence map›Paper›PMID 32404059›Full record

Trial reportBMC geriatrics2020

Effectiveness of a community program for older adults with type 2 diabetes and multimorbidity: a pragmatic randomized controlled trial.

John J Miklavcic, Kimberly D Fraser, Jenny Ploeg, Maureen Markle-Reid, Kathryn Fisher, Amiram Gafni, Lauren E Griffith, Sandra Hirst, Cheryl A Sadowski, Lehana Thabane and 2 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC geriatrics, 2020. 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 34 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 7 pooled it
3.3field-weighted citation impact, top 7% 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

34 citing papers in PubMed, 7 syntheses or guidelines pooled it, 54 citations in OpenAlex.

  1. Pooled it
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  5. 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
    Pooled it
  6. Pooled it
  7. Pooled it
  8. Trial
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  13. Review
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  18. Multimorbidity Management: A Scoping Review of Interventions and Health Outcomes.International journal of environmental research and public health · 2025
    Article
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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

12 authors at 5 institutions in 2 countries.

John J MiklavcicSchmid College of Science and Technology, Chapman University, Orange, California, 92866, USA.ORCID 0000-0001-7676-1939
Kimberly D FraserFaculty of Nursing, University of Alberta, Edmonton, Alberta, T6G2R3, Canada.
Jenny PloegSchool of Nursing, and Scientific Director, Aging, Community and Health Research Unit, School of Nursing McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada. ploegj@mcmaster.ca.ORCID 0000-0001-8168-8449
Maureen Markle-ReidAging, Community and Health Research Unit, School of Nursing, McMaster University, Hamilton, Canada.ORCID 0000-0002-4019-7077
Kathryn FisherAging, Community and Health Research Unit, School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.ORCID 0000-0001-8342-1238
Amiram GafniDepartment of Health Research Methods, Evidence, and Impact; and Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, L8S 4K1, Canada.ORCID 0000-0001-8279-8172
Lauren E GriffithDepartment of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.ORCID 0000-0002-2794-9692
Sandra HirstFaculty of Nursing, University of Calgary, Calgary, Alberta, T2N 1N4, Canada.
Cheryl A SadowskiFaculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 3-171 Edmonton Clinic Health Academy, Edmonton, Alberta, T6G 1C9, Canada.ORCID 0000-0002-4526-7054
Lehana ThabaneDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, L8S 4K1, Canada.
Jean A C TriscottCare of the Elderly Division, Glenrose Rehabilitation Hospital, Rm 1244 10230-111 Avenue, Edmonton, Alberta, T5G 0B7, Canada.ORCID 0000-0002-6383-5887
Ross UpshurDivision of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Room 678 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
University of Alberta · CAImpact · CAMcMaster University · CAUniversity of Calgary · CAUniversity of Toronto · CA

Funding

Canadian Institute of Health Research Tier 2 Canada Research Chair 950-231515Canadian Institutes of Health Research Signature Initiative in Community-Based Primary Healthcare TTF 128261Ontario Ministry of Health and Long-Term Care Health System Research Fund Program 06669
6 · The paper itself

Abstract

backgroundType II diabetes mellitus (T2DM) affects upwards of 25% of Canadian older adults and is associated with high comorbidity and burden. Studies show that lifestyle factors and self-management are associated with improved health outcomes, but many studies lack rigour or exclude older adults, particularly those with multimorbidity. More evidence is needed on the effectiveness of community-based self-management programs in older adults with T2DM and multimorbidity. The study purpose is to evaluate the effect of a community-based intervention versus usual care on physical functioning, mental health, depressive symptoms, anxiety, self-efficacy, self-management, and healthcare costs in older adults with T2DM and 2 or more comorbidities.

methodsCommunity-living older adults with T2DM and two or more chronic conditions were recruited from three Primary Care Networks (PCNs) in Alberta, Canada. Participants were randomly allocated to the intervention or control group in this pragmatic randomized controlled trial comparing the intervention to usual care. The intervention involved up to three in-home visits, a monthly group wellness program, monthly case conferencing, and care coordination. The primary outcome was physical functioning. Secondary outcomes included mental functioning, anxiety, depressive symptoms, self-efficacy, self-management, and the cost of healthcare service use. Intention-to-treat analysis was performed using ANCOVA modeling.

resultsOf 132 enrolled participants (70-Intervention, 62-Control), 42% were 75 years or older, 55% were female, and over 75% had at least six chronic conditions (in addition to T2DM). No significant group differences were seen for the baseline to six-month change in physical functioning (mean difference: -0.74; 95% CI: - 3.22, 1.74; p-value: 0.56), mental functioning (mean difference: 1.24; 95% CI: - 1.12, 3.60; p-value: 0.30), or other secondary outcomes..

conclusionNo significant group differences were seen for the primary outcome, physical functioning (PCS). Program implementation, baseline differences between study arms and chronic disease management services that are part of usual care may have contributed to the modest study results. Fruitful areas for future research include capturing clinical outcome measures and exploring the impact of varying the type and intensity of key intervention components such as exercise and diet.

trial registrationNCT02158741 Date of registration: June 9, 2014.

Indexed as

Diabetes Mellitus, Type 2Self-ManagementAgedCanadaFemaleHumansMaleMultimorbidityQuality of LifeAgingCommunity-based programComorbidityOlder adultsSelf-managementType 2 diabetes mellitus

Identifiers

PMID32404059
PMCPMC7218835
OpenAlexW3024310883

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.