Carmienke Solveig, Geier Anne-Kathrin, Deutsch Tobias, Rasche Franz Maximilian, Frese Thomas
Institute of General Practice and Family Medicine, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle, Germany.
Department of General Practice, Medical Faculty, University of Leipzig, Leipzig, Germany.
Exp Clin Endocrinol Diabetes. 2020 Mar;128(3):190-198. doi: 10.1055/a-0803-0362. Epub 2019 Feb 12.
Comprehensive geriatric assessments are established tools for the identification of health problems in the elderly. So far, little is known about tailoring and targeting to facilitate their application. As a starting point for a tailored assessment of patients with diabetes, a highly prevalent health condition, we aimed to assess if the Standardized Assessment of Elderly People (STEP) is able to identify relevant differences in self-reported health problems between diabetic and non-diabetic patients.
We performed a secondary analysis of a cross-sectional study including 1007 adults (aged 65 and older) from 28 German general practices, evaluating the feasibility and usefulness of the self-administered STEP version. For this exploratory study we re-analysed the data and compared patients with and without diabetes.
Out of 940 patients included in the secondary analysis, 248 (26.4%) had diabetes. Compared to non-diabetic patients, geriatric diabetic patients reported more often problems in activities of daily living, physical problems typically associated with diabetes such as urinary incontinence, visual impairment, mood disturbances, as well as the use of medical or social services. Most of our results were stable after adjusting for age, sex and body mass index.
We conclude that the self-administered version of the STEP tool may be used to screen for health problems typically associated with diabetes. Our results may guide the development of a tailored STEP-version specifically for diabetic patients. Further research might evaluate the adoption and usefulness of such a tool in every-day general practice.
综合老年评估是识别老年人健康问题的既定工具。到目前为止,对于如何调整和针对性应用以促进其使用了解甚少。作为对糖尿病患者(一种高度常见的健康状况)进行针对性评估的起点,我们旨在评估老年人标准化评估(STEP)是否能够识别糖尿病患者和非糖尿病患者在自我报告的健康问题方面的相关差异。
我们对一项横断面研究进行了二次分析,该研究纳入了来自28家德国普通诊所的1007名成年人(年龄在65岁及以上),评估了自行填写的STEP版本的可行性和实用性。对于这项探索性研究,我们重新分析了数据,并比较了有糖尿病和无糖尿病的患者。
在纳入二次分析的940名患者中,248名(26.4%)患有糖尿病。与非糖尿病患者相比,老年糖尿病患者在日常生活活动方面报告的问题更多,还有与糖尿病相关的身体问题,如尿失禁、视力障碍、情绪障碍以及医疗或社会服务的使用。在对年龄、性别和体重指数进行调整后,我们的大多数结果是稳定的。
我们得出结论,STEP工具的自行填写版本可用于筛查通常与糖尿病相关的健康问题。我们的结果可能会指导专门针对糖尿病患者的STEP版本的开发。进一步的研究可以评估这种工具在日常普通实践中的采用情况和实用性。