Engaging family supporters of adult patients with diabetes to improve clinical and patient-centered outcomes: study protocol for a randomized controlled trial.
Engaging family supporters of adult patients with diabetes to improve clinical and patient-centered outcomes: study protocol for a randomized controlled trial.
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DOI：
10.1186/s13063-018-2785-2
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发表时间：
2018-07-24
期刊：
影响因子：
2.5
通讯作者：
Heisler M
中科院分区：
文献类型：
--
作者：
Rosland AM;Piette JD;Trivedi R;Kerr EA;Stoll S;Tremblay A;Heisler M
大多数患有糖尿病的成年人有并发症的高风险，他们的家人或朋友参与了他们的医疗和自我护理(“家庭支持者”)。这些家庭支持者是一个重要的资源，可以利用他们来改善患者对他们的护理和患者健康结果的参与度。然而，医疗团队缺乏系统和可行的方法来有效地让家庭支持者参与患者自我管理支持。这项试验测试了一项战略，以加强家庭支持者的能力，以帮助患有高危糖尿病的成年人参与医疗保健，成功制定护理计划，并降低糖尿病并发症的风险。我们将进行一项随机试验，评估CO-IMPACT(关怀他人，增加患者对齐护理团队的参与)干预措施。两名被追捕的40名患有糖尿病的成年人，由于血糖控制不佳或高血压而有糖尿病并发症的高风险，将与一名家庭支持者(与患者或远程居住)一起随机接受12个月的CO-IMPACT或加强常规初级护理。Co-Impact提供患者-支持者二人组：它提供一次指导会议，介绍帮助患者改变行为的动机、行动计划和与医疗保健提供者的主动沟通的支持人员技术；两周一次的自动电话呼叫，以提示对新的患者健康问题的二元组行动；电话，以提示患者的初级保健访问准备；以及发送给患者和支持者的初级保健访问摘要。主要结果是以患者激活测量-13衡量的患者活跃度的变化，以及根据英国糖尿病前瞻性研究糖尿病患者的心脏风险评分衡量的5年心脏事件风险的变化。次要结果包括患者的糖尿病自我管理行为、糖尿病痛苦、血糖和血压控制。支持者的措施将包括使用有效的支持技术，负担和痛苦患者的糖尿病护理。如果在改善患者活动和糖尿病管理方面有效，CO-Impact将为医疗团队提供基于证据的工具和技术，让患者有空的家人或朋友参与支持患者的自我管理，即使他们生活在偏远地区。随着时间的推移，患者和他们的支持者可以使用CO-Impact解决的核心技能来应对不断变化的患者健康需求和优先事项。临床试验.gov，NCT02328326。注册日期为2014年12月31日。本文的在线版本(10.1186/s13063-0182785-2)包含补充材料，可供授权用户使用。
Most adults with diabetes who are at high risk for complications have family or friends who are involved in their medical and self-care (“family supporters”). These family supporters are an important resource who could be leveraged to improve patients’ engagement in their care and patient health outcomes. However, healthcare teams lack structured and feasible approaches to effectively engage family supporters in patient self-management support. This trial tests a strategy to strengthen the capacity of family supporters to help adults with high-risk diabetes engage in healthcare, successfully enact care plans, and lower risk of diabetes complications. We will conduct a randomized trial evaluating the CO-IMPACT (Caring Others Increasing EnageMent in Patient Aligned Care Teams) intervention. Two hunded forty adults with diabetes who are at high risk for diabetes complications due to poor glycemic control or high blood pressure will be randomized, along with a family supporter (living either with the patient or remotely), to CO-IMPACT or enhanced usual primary care for 12 months. CO-IMPACT provides patient-supporter dyads: it provides one coaching session addressing supporter techniques for helping patients with behavior change motivation, action planning, and proactive communication with healthcare providers; biweekly automated phone calls to prompt dyad action on new patient health concerns; phone calls to prompt preparation for patients’ primary care visits; and primary care visit summaries sent to both patient and supporter. Primary outcomes are changes in patient activation, as measured by the Patient Activation Measure-13, and change in 5-year cardiac event risk, as measured by the United Kingdom Prospective Diabetes Study cardiac risk score for people with diabetes. Secondary outcomes include patients’ diabetes self-management behaviors, diabetes distress, and glycemic and blood pressure control. Measures among supporters will include use of effective support techniques, burden, and distress about patient’s diabetes care. If effective in improving patient activation and diabetes management, CO-IMPACT will provide healthcare teams with evidence-based tools and techniques to engage patients’ available family or friends in supporting patient self-management, even if they live remotely. The core skills addressed by CO-IMPACT can be used by patients and their supporters over time to respond to changing patient health needs and priorities. ClinicalTrials.gov, NCT02328326. Registered on 31 December 2014. The online version of this article (10.1186/s13063-018-2785-2) contains supplementary material, which is available to authorized users.
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DOI：
10.1111/j.1742-1241.2008.01872.x
发表时间：
2008-10-01
影响因子：
2.6
作者：
Benner, J. S.;Erhardt, L.;Girerd, X.
通讯作者：
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影响因子：
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作者：
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DOI：
10.1177/014572179101700507
发表时间：
1991-09-01
期刊：
The Diabetes educator
影响因子：
--
作者：
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通讯作者：
Connell, C M
影响因子：
5.7
作者：
Chew, Lisa D.;Griffin, Joan M.;VanRyn, Michelle
通讯作者：
VanRyn, Michelle
影响因子：
2.6
作者：
DiIorio, C;Shafer, PO;Yeager, K
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Yeager, K