German Clinical Trials Register

Acronym/abbreviation of the study

BAIDIA II

URL of the study

http://web.uk-halle.de/index.php?id=5127

Brief summary in lay language

The BAIDIA I enquiry showed that between general practitioners, medical assistants and care workers remarkable mutual information deficits prevail in view of therapy aims, therapy instructions (e.g. insulin schemes and insulin doses), therapy follow-up, report intervals and indications for mutual sharing of information as well as home visits. A format for a systematic ensuring of understanding as well as a covering of therapy aims respectively power to act is needed. Such a format for a standardised exchange of information could be (with a positive evaluation and broader implementation) a relevant indicator for remuneration of structural quality in selective or collective treatment contracts between general practitioners, care workers and medical insurance companies in the future. Therefore the pilot study BAIDIA II not only foculises on clinical relevant endpoints of diabets bt also on the improvement of actual treatment reality older type 2 diabetics, inter-professional approach to therapy options and in view of interverntion on the communicative transfer of therapy management (doctor) to realised therapy and its possible complications (care).

Brief summary in scientific language

The prevalence of diabetes mellitus rises up to 20 percent in the age group of over 70 years old besides a demographic dependent proportion of geriatric patients at the general medical care. While an intensive and complex diabetes therapy for non-geriatric patients is more beneficial for morbidity processes, an intensified diabetes therapy for geriatric patients is valued more often as complicated and since the ACCORD study more and more reluctant. With the discussion about an adequate diabetes therapy for geriatric patients comes the question, how demands on an autonomous cooperation of this patient group can be realised, to the fore. Since the insulin utilization and the daily dealing with the disease (diet, dining intervals etc.) ist not only ensured by the patients itself but by fostering people from domestic environment or professional care workers. Guidelines for diagnostic and therapy of diabetes can not unconditional be transferred on the observed geriatric clientele but require transmission into individualised guidance for patients and their fostering relatives resp. care workers. The BAIDIA I study revealed, with the help of interviews with general practitioners, their medical assistants and professional care workers, mutual coordination- and information-needs between the involved occupational groups. Especially care workers required appropriate insulin therapy-schemes with information about measurement-dependent dose-correction, general practitioners required prompt information about diabetes lapses and care- resp. supply-problems. Therefore focuses the submitted follow-up study BAIDIA II on an enhancement of supply reality of older type 2 diabetics by the use of a standardised fax-based communication tool between care workers and general practitioners.