Diabetes, Diabetes Mellitus
Conditions
Keywords
Community paramedicine, Diabetes mellitus, Diabetes distress
Brief summary
The purpose of this study is evaluate the effectiveness of Diabetes-REM (Rescue, Engagement, and Management), a comprehensive community paramedic (CP) program to support adults in Southeast Minnesota (Mower, Freeborn, and Olmsted counties) and Northwest Wisconsin (Barron, Rusk, and Dunn) who have uncontrolled diabetes (HbA1c ≥ 9%) and have experienced an emergency department (ED) visit or hospitalization for any cause in the prior 6 months.
Interventions
OTHERDiabetes-REM Program
A comprehensive community paramedicine management program designed to support adults with uncontrolled diabetes and a recent emergency department visit or hospitalization
Sponsors
Mayo Clinic
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
(Patients): * Most recent hemoglobin A1c ≥ 9% within the last 2 years. * Age ≥ 18 years old. * Type 1 or type 2 diabetes. * Paneled to a Mayo Clinic or Mayo Clinic Health System practice. * Able to provide informed consent. * Proficient in English. * Community-dwelling. * Live in Southeast Minnesota (Mower, Freeborn, or Olmsted counties) or Northwest Wisconsin (Barron, Rusk, or Dunn counties). Inclusion Criteria (Paramedics): •Community Paramedics who delivered the Diabetes-REM intervention.
Exclusion criteria
* Cognitive impairment precluding informed consent. * Lack of conversational English skills. * Resident of a long-term care facility. * Enrolled in hospice. * Enrolled in a care coordination or disease management program. * Advanced or terminal illness.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diabetes Distress (using DDS) | 1 month | The level of diabetes-related distress that is expressed by patient participants using the Diabetes Distress Scale (the DDS contains 17 questions, with responses ranging from Not a Problem (1) to A Very Serious Problem (6). Total scores use the sum of all responses divided by 17, with a mean item score of 3 or higher (moderate distress) indicating distress worthy of clinical attention.) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Diabetes Distress (using DDS) | 4 months | The level of diabetes-related distress that is expressed by patient participants using the Diabetes Distress Scale (the DDS contains 17 questions, with responses ranging from Not a Problem (1) to A Very Serious Problem (6). Total scores use the sum of all responses divided by 17, with a mean item score of 3 or higher (moderate distress) indicating distress worthy of clinical attention.) |
| Confidence in Diabetes Self-Management (using DSMQ) | 1 and 4 months | The level of confidence patient participants express in managing their diabetes using the Diabetes Self-Management Questionnaire (DSMQ) |
| Health-Related Quality of Life (using EQ-5D) | 1 and 4 months | Patients participants' self-reported health-related quality of life using the EuroQol 5-D (also known as EQ-5D; an instrument for measuring quality of life) |
| Self-Reported Hypoglycemia and Hyperglycemia | 1 and 4 months | Incidences of hypoglycemia (blood glucose \<70 mg/dL and \<54 mg/dL) and hyperglycemia (blood glucose ≥250 mg/dL) as reported by patient participants |
Countries
United States
Outcome results
None listed