RT Journal Article
T1 Effectiveness of an intervention to improve diabetes self-management on clinical outcomes in patients with low educational level
A1 de Labry Lima, Antonio Olry
A1 Bermudez Tamayo, Clara
A1 Pastor Moreno, Guadalupe
A1 Bolivar Munoz, Julia
A1 Ruiz Perez, Isabel
A1 Johri, Mira
A1 Quesada Jimenez, Fermin
A1 Cruz Vela, Pilar
A1 de Los Rios Alvarez, M.
A1 Prados Quel, Miguel Angel
A1 Moratalla Lopez, Enrique
A1 Dominguez Martin, Susana
A1 Lopez de Hierro, Jose Andres
A1 Ricci Cabello, Ignacio
K1 Diabetes mellitus type 2
K1 Primary health care
K1 Health inequalities
K1 Self care
K1 Randomised controlled trial
K1 Socioeconomic inequalities
K1 Care
K1 Mellitus
K1 Prevalence
K1 Americans
K1 Position
K1 Women
K1 Trial
AB Objective: To determine whether an intervention based on patient-practitioner communication is more effective than usual care in improving diabetes self-management in patients with type 2 diabetes with low educational level.Methods: 12-month, pragmatic cluster randomised controlled trial. Nine physicians and 184 patients registered at two practices in a deprived area of Granada (Andalusia, Spain) participated in the study. Adult patients with type 2 diabetes, low educational level and glycated haemoglobin (HbAlc) > 7% (53.01 mmol/mol) were eligible. The physicians in the intervention group received training on communication skills and the use of a tool for monitoring glycaemic control and providing feedback to patients. The control group continued standard care. The primary outcome was difference in HbAl c after 12 months. Dyslipidaemia, blood pressure, body mass index and waist circumference were also assessed as secondary outcomes. Two-level (patient and provider) regression analyses controlling for sex, social support and comorbidity were conducted.Results: The HbAl c levels at 12 months decreased in both groups. Multilevel analysis showed a greater improvement in the intervention group (between-group HbAl c difference=0.16; p = 0.049). No statistically significant differences between groups were observed for dyslipidaemia, blood pressure, body mass index and waist circumference.Conclusions: In this pragmatic study, a simple and inexpensive intervention delivered in primary care showed a modest benefit in glycaemic control compared with usual care, although no effect was observed in the secondary outcomes. Further research is needed to design and assess interventions to promote diabetes self-management in socially vulnerable patients. (C) 2016 SESPAS. Published by Elsevier Espaila, S.L.U.
PB Elsevier
SN 0213-9111
YR 2017
FD 2017-01-01
LK http://hdl.handle.net/10668/18786
UL http://hdl.handle.net/10668/18786
LA en
DS RISalud
RD Apr 6, 2025