Dementia, Diabetes, Hypoglycemia; Drug
Conditions
Keywords
older adults, long term care facility, high risk medications, hypoglycemia, deprescribing, diabetes, dementia
Brief summary
Objectives To 1) examine the ability of the STRIDE (Simplification of Treatment Regimens and Individualized Diabetes Education) educational program to increase deprescribing of high hypoglycemia risk glucose-lowering medications (HRMs) among long term care facility (LTCF) residents with ADRD, 2) assess key implementation constructs (secondary outcomes) of the STRIDE program, including acceptability, appropriateness, and feasibility, and 3) validate the primary HRM use outcome measure.
Interventions
BEHAVIORALSTRIDE
a. Targeted providers for STRIDE program: i. Clinical staff at the LTCF who participate in deprescribing at the facilities (physicians (MDs), physician's assistants (PAs), nurse practitioners (NPs), clinical pharmacists): clinical staff members caring for LTCF residents with ADRD and diabetes at 6 LTCFs in the Ohio and Michigan areas will be invited via email from the LTCF leadership to participate in the STRIDE education program. The STRIDE program consist of practical algorithms and educational material, which they are free to view at any time, and participation in 2 webinars and monthly telementoring calls
Sponsors
Brown University
Theoria Medical
Joslin Diabetes Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Clinical staff at the LTCF (MDs, PAs, NPs, clinical pharmacists) - (Targeted providers for STRIDE program) * Clinical staff that participated in the STRIDE program (Providers doing stakeholder exit interviews)
Exclusion criteria
* Consistent with the pragmatic nature of the trial, there are no
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in proportion of long term care facility (LTCF) residents with Alzheimer's disease adn related dementias (ADRD) and diabetes with high risk medications (HRM) use | Baseline vs 6 months | HRM use will include any sulfonylurea use (i.e., glyburide, glipizide, glimepiride, or chlorpropamide) and any insulin use. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Acceptability of the STRIDE Educational Program | 6 months | The extent to which the program is agreeable to LTCF staff- using the Acceptability of Intervention Measure (AIM) |
| Appropriateness of the STRIDE Educational Program | 6 months | The extent to which the program is suitable for a particular purpose, i.e., to improve the frequency at which LTCF staff attempt diabetes medication regimen deprescribing- using the Intervention Appropriateness Measure (IAM) |
| Feasibility of the STRIDE Educational Program | 6 months | The extent to which the program is practical at the LTCF level- using the Feasibility of Intervention Measure (FIM) |
Countries
United States
Outcome results
None listed