Care Coordination of Older Adults With Diabetes: A Scoping Review

Abstract

Objectives: Care coordination is a common intervention to support older adults with diabetes and their caregivers, and provides individualized, integrated health and social care. However, the optimal approach of care coordination is not well described. In this scoping review we synthesized evidence regarding the implementation of traditional and virtual care coordination for older adults with diabetes to inform future research and best practices.

Methods: The Joanna Briggs Institute scoping review methods were used. A systematic search was conducted in CINAHL, Embase, EmCare, and Medline, as well as a targeted grey literature search, and a hand-search of reference lists. Screening and data extraction were completed by 3 independent reviewers.

Results: Forty-two articles were included in the synthesis. Included studies operationalized care coordination in different ways. The most commonly implemented elements of care coordination were regular communication and monitoring. In contrast, coordination between health-care teams and the community, individualized planning, and caregiver involvement were less often reported. Outcomes to evaluate the impact of care coordination were predominantly diabetes-centric, and less often person-centred. In addition, evidence indicates that older adults value a trusting relationship with their care coordinator.

Conclusions: Studies assessing care coordination for older adults with diabetes have shown positive outcomes. To inform best practices, future intervention research for this population should focus on evaluating the impact of comprehensive care planning, system navigation across the health and social care sectors, the care coordinator and patient relationship and caregiver support.

Keywords: besoins complexes; care coordination; complex needs; coordination des soins; diabetes mellitus; diabète sucré; integrated care; older adults; personnes âgées; soins intégrés; soins virtuels; virtual care.