International trial shows significant beneficial effects of a multi-modal intervention scheme
16 May 2019
The MID-Frail study – soon to be published in the Journal of Cachexia, Sarcopenia, and Muscle – compared multi-modal intervention to usual care in elderly people with type 2 diabetes. From study results, it is estimated that 700,000 fewer cases of diabetes-caused disabilities would occur each year, and an average of €3 billion per year would be saved by the healthcare sector if the intervention route was followed.
The study compared 946 subjects from 74 trial sites in 7 EU countries, used interventions designed to improve functional status and enhance quality of life by acting on frailty mechanisms. Education, diet, and exercise regimes were implemented and the difference in function (changes in the summary ordinal score on the short physical performance battery (SPPB)) was measured. The intervention group subjects had mean SPPB scores 0.85 points higher than those in the usual care group. Moreover, it is estimated from this study that the average cost of a type 2 diabetes patient over the age of 70 can be reduced by €428.02 per patient per year. Taken together, the results of MID-Frail indicates that a multi-modal method to treat older frail people with diabetes were beneficial both to function and the economic effect on healthcare.
Diabetes is a highly prevalent disease - caused by the ineffectual production or use of insulin - that greatly affects older people aged 70 and above. It causes serious personal consequences such as increasing frailty and functional decline, leading to unintentional weight loss, exhaustion, low level of physical activity, and weakness. Additionally, 28% of the elderly with type 2 diabetes require help with daily living activities compared to 16% of non-diabetes subjects; this costs between €2108 and €2928 per patient, a great burden to the healthcare system. But through the implementation of the multi-modal intervention from the MID-Frail study, the cost per patient can be reduced by approximately 20%.
This study is the largest international trial of its kind so far, displaying significant beneficial effects of a multi-modal intervention scheme. The programme has resulted in higher functional status and lower healthcare costs, and provided a legacy of benefits to the participants long after the educational and physical sections had finished. Its findings are significant to this demographic and can be applied to a variety of clinical settings.