Diabetes in care homes: a cluster randomised controlled trial of resident education

Abstract

Introduction

Residents of care homes with diabetes are a vulnerable group, lacking comprehensive assessment, monitoring, and specialist access. This study aimed to determine whether a short-term patient centred intervention strategy might benefit people with diabetes living in residential care homes.

Methods

Residents with diabetes were recruited and randomised (by care home) to intervention (25 homes: 57 residents) or control (26 homes: 45 residents). The intervention consisted of a medical review and individualised resident educational programme. The control group received usual care. Measures of glycaemic control (fasting glucose and HbA_1c), quality of life, functional ability, cognition, mood, and diabetes knowledge were collected at baseline and after 6 months.

Results

After 6 months the intervention group, compared with control, had better quality of life, mood and diabetes knowledge and a slight increase in HbA_1c from a mean value of 6.84 % (1.54) to 7.49 % (1.82). Reports of hypoglycaemia were less at the end of the study in both groups.

Conclusions

The intervention improved patient-centred outcomes, with a small effect on glycaemic control. More research needs to be performed with care home residents to develop the evidence base for appropriate interventions in this neglected group of patients.