Enhancing care in the initiation and management of insulin in older people with diabetes: A collaborative journey with older individuals and their caregivers using Experience-Based Co-Design
Initiating insulin therapy in older individuals with type 2 diabetes (T2DM) poses unique challenges and requires a nuanced understanding of the age-related factors that impact safety and efficacy. This study employed Experience-Based Co-Design (EBCD) to enhance the insulin initiation and management...
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| description | Initiating insulin therapy in older individuals with type 2 diabetes (T2DM) poses unique challenges and requires a nuanced understanding of the age-related factors that impact safety and efficacy. This study employed Experience-Based Co-Design (EBCD) to enhance the insulin initiation and management experience for this population, emphasising a collaborative approach involving patients, caregivers, and healthcare professionals.
The primary aim of the research was to develop a tailored care pathway, utilising co-design and the Behaviour Change Wheel (BCW), which addressed issues specific to older adults on insulin therapy. The study sought to identify key challenges, propose practical interventions, and construct a logic model illustrating a pathway for enhanced insulin treatment experiences.
An adapted EBCD process was used which integrated the Medical Research Council (MRC) Framework and BCW. The study involved thematic synthesis, video interviews, and feedback focus groups with patients, caregivers, and healthcare professionals. The 'Crazy Eights' brainstorming method, as part of the co-design workshop, generated practical solutions which informed subsequent logic model development.
Focus group findings revealed distressing insulin initiation experiences, inconsistent dietary advice, and perceived disparities in care between type 1 and type 2 diabetes. The co-design workshop identified eight key challenges, leading to proposed interventions aligned with the BCW. The logic model illustrates a pathway for older individuals undergoing insulin treatment, emphasising behaviour change among patients, caregivers, and healthcare professionals.
The collaborative efforts of participants contributed valuable insights in terms of the unique educational and emotional needs of patients, the importance of care continuity and of improving access to specialist services. Findings from this study can be used to inform and enhance tailored support strategies for older adults with T2DM during their insulin transition and ongoing management. |
| doi_str_mv | 10.1371/journal.pone.0302516 |
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The primary aim of the research was to develop a tailored care pathway, utilising co-design and the Behaviour Change Wheel (BCW), which addressed issues specific to older adults on insulin therapy. The study sought to identify key challenges, propose practical interventions, and construct a logic model illustrating a pathway for enhanced insulin treatment experiences.
An adapted EBCD process was used which integrated the Medical Research Council (MRC) Framework and BCW. The study involved thematic synthesis, video interviews, and feedback focus groups with patients, caregivers, and healthcare professionals. The 'Crazy Eights' brainstorming method, as part of the co-design workshop, generated practical solutions which informed subsequent logic model development.
Focus group findings revealed distressing insulin initiation experiences, inconsistent dietary advice, and perceived disparities in care between type 1 and type 2 diabetes. The co-design workshop identified eight key challenges, leading to proposed interventions aligned with the BCW. The logic model illustrates a pathway for older individuals undergoing insulin treatment, emphasising behaviour change among patients, caregivers, and healthcare professionals.
The collaborative efforts of participants contributed valuable insights in terms of the unique educational and emotional needs of patients, the importance of care continuity and of improving access to specialist services. Findings from this study can be used to inform and enhance tailored support strategies for older adults with T2DM during their insulin transition and ongoing management.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0302516</identifier><identifier>PMID: 39074147</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adults ; Age ; Aged ; Aged, 80 and over ; Analysis ; Biology and Life Sciences ; Caregivers ; Caregivers - psychology ; Co-design ; Collaboration ; Computer software industry ; Diabetes ; Diabetes mellitus (insulin dependent) ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - psychology ; Diabetes Mellitus, Type 2 - therapy ; Diabetes therapy ; Diabetics ; Diet ; Disease management ; Emotional behavior ; Female ; Focus Groups ; Frailty ; Gerontology ; Health care ; Health services ; Humans ; Hypoglycemic Agents - therapeutic use ; Insulin ; Insulin - therapeutic use ; Intervention ; Logic ; Male ; Medical personnel ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; Middle Aged ; Older people ; Patients ; People and Places ; Professionals ; Social Sciences ; Type 2 diabetes ; Workshops</subject><ispartof>PloS one, 2024-07, Vol.19 (7), p.e0302516</ispartof><rights>Copyright: © 2024 Langerman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Langerman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Langerman et al 2024 Langerman et al</rights><rights>2024 Langerman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c572t-41410b6bdf9ac4a68d0d8dee055baffb26c2855ac9f88bfaf65d7de4f17341c03</cites><orcidid>0000-0001-8781-6675 ; 0000-0002-2688-1497</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285973/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285973/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23870,27928,27929,53795,53797</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39074147$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Tan, Chai-Eng</contributor><creatorcontrib>Langerman, Chaya</creatorcontrib><creatorcontrib>Forbes, Angus</creatorcontrib><creatorcontrib>Robert, Glenn</creatorcontrib><title>Enhancing care in the initiation and management of insulin in older people with diabetes: A collaborative journey with older individuals and their caregivers using Experience-Based Co-Design</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Initiating insulin therapy in older individuals with type 2 diabetes (T2DM) poses unique challenges and requires a nuanced understanding of the age-related factors that impact safety and efficacy. This study employed Experience-Based Co-Design (EBCD) to enhance the insulin initiation and management experience for this population, emphasising a collaborative approach involving patients, caregivers, and healthcare professionals.
The primary aim of the research was to develop a tailored care pathway, utilising co-design and the Behaviour Change Wheel (BCW), which addressed issues specific to older adults on insulin therapy. The study sought to identify key challenges, propose practical interventions, and construct a logic model illustrating a pathway for enhanced insulin treatment experiences.
An adapted EBCD process was used which integrated the Medical Research Council (MRC) Framework and BCW. The study involved thematic synthesis, video interviews, and feedback focus groups with patients, caregivers, and healthcare professionals. The 'Crazy Eights' brainstorming method, as part of the co-design workshop, generated practical solutions which informed subsequent logic model development.
Focus group findings revealed distressing insulin initiation experiences, inconsistent dietary advice, and perceived disparities in care between type 1 and type 2 diabetes. The co-design workshop identified eight key challenges, leading to proposed interventions aligned with the BCW. The logic model illustrates a pathway for older individuals undergoing insulin treatment, emphasising behaviour change among patients, caregivers, and healthcare professionals.
The collaborative efforts of participants contributed valuable insights in terms of the unique educational and emotional needs of patients, the importance of care continuity and of improving access to specialist services. Findings from this study can be used to inform and enhance tailored support strategies for older adults with T2DM during their insulin transition and ongoing management.</description><subject>Adults</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Caregivers</subject><subject>Caregivers - psychology</subject><subject>Co-design</subject><subject>Collaboration</subject><subject>Computer software industry</subject><subject>Diabetes</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - psychology</subject><subject>Diabetes Mellitus, Type 2 - therapy</subject><subject>Diabetes therapy</subject><subject>Diabetics</subject><subject>Diet</subject><subject>Disease management</subject><subject>Emotional behavior</subject><subject>Female</subject><subject>Focus Groups</subject><subject>Frailty</subject><subject>Gerontology</subject><subject>Health care</subject><subject>Health services</subject><subject>Humans</subject><subject>Hypoglycemic Agents - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Langerman, Chaya</au><au>Forbes, Angus</au><au>Robert, Glenn</au><au>Tan, Chai-Eng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Enhancing care in the initiation and management of insulin in older people with diabetes: A collaborative journey with older individuals and their caregivers using Experience-Based Co-Design</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-07-29</date><risdate>2024</risdate><volume>19</volume><issue>7</issue><spage>e0302516</spage><pages>e0302516-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Initiating insulin therapy in older individuals with type 2 diabetes (T2DM) poses unique challenges and requires a nuanced understanding of the age-related factors that impact safety and efficacy. This study employed Experience-Based Co-Design (EBCD) to enhance the insulin initiation and management experience for this population, emphasising a collaborative approach involving patients, caregivers, and healthcare professionals.
The primary aim of the research was to develop a tailored care pathway, utilising co-design and the Behaviour Change Wheel (BCW), which addressed issues specific to older adults on insulin therapy. The study sought to identify key challenges, propose practical interventions, and construct a logic model illustrating a pathway for enhanced insulin treatment experiences.
An adapted EBCD process was used which integrated the Medical Research Council (MRC) Framework and BCW. The study involved thematic synthesis, video interviews, and feedback focus groups with patients, caregivers, and healthcare professionals. The 'Crazy Eights' brainstorming method, as part of the co-design workshop, generated practical solutions which informed subsequent logic model development.
Focus group findings revealed distressing insulin initiation experiences, inconsistent dietary advice, and perceived disparities in care between type 1 and type 2 diabetes. The co-design workshop identified eight key challenges, leading to proposed interventions aligned with the BCW. The logic model illustrates a pathway for older individuals undergoing insulin treatment, emphasising behaviour change among patients, caregivers, and healthcare professionals.
The collaborative efforts of participants contributed valuable insights in terms of the unique educational and emotional needs of patients, the importance of care continuity and of improving access to specialist services. Findings from this study can be used to inform and enhance tailored support strategies for older adults with T2DM during their insulin transition and ongoing management.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39074147</pmid><doi>10.1371/journal.pone.0302516</doi><tpages>e0302516</tpages><orcidid>https://orcid.org/0000-0001-8781-6675</orcidid><orcidid>https://orcid.org/0000-0002-2688-1497</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2024-07, Vol.19 (7), p.e0302516 |
| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; Public Library of Science (PLoS) Journals Open Access; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adults Age Aged Aged, 80 and over Analysis Biology and Life Sciences Caregivers Caregivers - psychology Co-design Collaboration Computer software industry Diabetes Diabetes mellitus (insulin dependent) Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - psychology Diabetes Mellitus, Type 2 - therapy Diabetes therapy Diabetics Diet Disease management Emotional behavior Female Focus Groups Frailty Gerontology Health care Health services Humans Hypoglycemic Agents - therapeutic use Insulin Insulin - therapeutic use Intervention Logic Male Medical personnel Medical research Medicine and Health Sciences Medicine, Experimental Middle Aged Older people Patients People and Places Professionals Social Sciences Type 2 diabetes Workshops |
| title | Enhancing care in the initiation and management of insulin in older people with diabetes: A collaborative journey with older individuals and their caregivers using Experience-Based Co-Design |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-17T09%3A23%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Enhancing%20care%20in%20the%20initiation%20and%20management%20of%20insulin%20in%20older%20people%20with%20diabetes:%20A%20collaborative%20journey%20with%20older%20individuals%20and%20their%20caregivers%20using%20Experience-Based%20Co-Design&rft.jtitle=PloS%20one&rft.au=Langerman,%20Chaya&rft.date=2024-07-29&rft.volume=19&rft.issue=7&rft.spage=e0302516&rft.pages=e0302516-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0302516&rft_dat=%3Cgale_plos_%3EA802992645%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3085948481&rft_id=info:pmid/39074147&rft_galeid=A802992645&rft_doaj_id=oai_doaj_org_article_274d68f2ab324f1381b7fbe5a9ee8a0c&rfr_iscdi=true |