A Randomized Study of the Effects of a Home Diabetes Education Program

B, Rettig; Shrauger, Dennis G; Recker, Robert R.; Gallagher, T. F.; Wiltse, Hobart E.

doi:10.2337/diacare.9.2.173

Cited by 95 publications

(50 citation statements)

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“…Litzelman et al (62) noted a decrease in serious foot lesions at 1 year after an intervention consisting of group education, with three follow-up visits, provider guidelines, and chart reminders. Other studies failed to demonstrate improvements with interventions (41,46,63). Malone et al (64) found a significant decrease in foot ulcer and amputation rates, although this study had significant methodological inadequacies.…”

Section: Process Measuresmentioning

confidence: 93%

“…Economic and health-care utilization outcomes Most studies examining economic outcomes and health-care utilization (Table 6) failed to demonstrate improvements in measured parameters (34,46,60), except the study by Wood (54), which demonstrated a decrease in emergency room visits 4 months after a short-duration intervention. Glasgow et al (68) calculated that the cost of a social cognitive theory-based lifestyle intervention, effective in decreasing cholesterol and in improving food habits, was $137 per patient.…”

Section: Continued On Following Pagementioning

confidence: 99%

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Effectiveness of Self-Management Training in Type 2 Diabetes

2001

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OBJECTIVE -To systematically review the effectiveness of self-management training in type 2 diabetes. RESEARCH DESIGN AND METHODS -MEDLINE, EducationalResources Information Center (ERIC), and Nursing and Allied Health databases were searched for English-language articles published between 1980 and 1999. Studies were original articles reporting the results of randomized controlled trials of the effectiveness of self-management training in people with type 2 diabetes. Relevant data on study design, population demographics, interventions, outcomes, methodological quality, and external validity were tabulated. Interventions were categorized based on educational focus (information, lifestyle behaviors, mechanical skills, and coping skills), and outcomes were classified as knowledge, attitudes, and self-care skills; lifestyle behaviors, psychological outcomes, and quality of life; glycemic control; cardiovascular disease risk factors; and economic measures and health service utilization.RESULTS -A total of 72 studies described in 84 articles were identified for this review. Positive effects of self-management training on knowledge, frequency and accuracy of selfmonitoring of blood glucose, self-reported dietary habits, and glycemic control were demonstrated in studies with short follow-up (Ͻ6 months). Effects of interventions on lipids, physical activity, weight, and blood pressure were variable. With longer follow-up, interventions that used regular reinforcement throughout follow-up were sometimes effective in improving glycemic control. Educational interventions that involved patient collaboration may be more effective than didactic interventions in improving glycemic control, weight, and lipid profiles. No studies demonstrated the effectiveness of self-management training on cardiovascular disease-related events or mortality; no economic analyses included indirect costs; few studies examined healthcare utilization. Performance, selection, attrition, and detection bias were common in studies reviewed, and external generalizability was often limited.CONCLUSIONS -Evidence supports the effectiveness of self-management training in type 2 diabetes, particularly in the short term. Further research is needed to assess the effectiveness of self-management interventions on sustained glycemic control, cardiovascular disease risk factors, and ultimately, microvascular and cardiovascular disease and quality of life. Diabetes Care 24:561-587, 2001D iabetes self-management training, the process of teaching individuals to manage their diabetes (1), has been considered an important part of clinical management since the 1930s (2). The goals of diabetes education are to optimize metabolic control, prevent acute and chronic complications, and optimize quality of life while keeping costs acceptable (3). One of the goals of Healthy People 2010 is to increase to 60% (from the 1998 baseline of 40%) the proportion of individuals with diabetes who receive formal diabetes education (4). There are significant knowledge and skill deficits in ...

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Section: Process Measuresmentioning

confidence: 93%

Section: Continued On Following Pagementioning

confidence: 99%

Effectiveness of Self-Management Training in Type 2 Diabetes

2001

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“…A reduced incidence of new foot ulcers has been shown when foot care education was included as part of an integrated package of diabetes care delivered to selected and relatively disadvantaged groups in the USA [12,13], but has not been confirmed in other studies [14][15][16][17][18][19].…”

mentioning

confidence: 99%

Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial

et al. 2008

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Aims/hypothesis This observer-blind, randomised controlled trial was designed to determine the effect of a foot care education programme in the secondary prevention of foot ulcers. Methods People with newly healed foot ulcers attending one of three specialist clinics were allocated to receive either targeted, one-to-one education or usual care, using a computer-generated random allocation sequence that had been prepared in advance but which was concealed from the clinical researcher. The primary outcome was ulcer incidence at 12 months. Secondary outcomes were ulcer incidence at 6 months and incidence of amputation, mood (Hospital Anxiety and Depression Scale) and quality of life (Diabetic Foot Ulcer Scale) at 6 and 12 months. Protective foot care behaviours (Nottingham Assessment of Functional Footcare) were assessed at 12 months. Results There were 87 (mean [SD] age 63.5 [12.1] years) patients in the intervention group and 85 control patients (mean [SD] age 64.9 [10.9] years). The groups were comparable at baseline. No significant differences (p> 0.05) were observed between groups in ulcer incidence at either 6 months (intervention 30%, control 21%) or 12 months (intervention 41%, control 41%). Recommended foot care behaviours at 12 months were better in the intervention than in the control group (p=0.03), but education had no significant (p>0.05) effect on mood, quality of life or amputations. Conclusions/interpretation Even though the intervention was associated with improved foot care behaviour, there was no evidence that this programme of targeted education was associated with clinical benefit in this population when compared with usual care. The usefulness and optimal delivery of education to such a high-risk group requires further evaluation.

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“…29 " 31 These studies generally emphasize the failure of information-oriented programs to alter behavior or improve metabolic control. However, as some researchers have suggested, psychological or motivational issues may be important factors in determining outcomes of educational interventions.…”

Section: " 28mentioning

confidence: 99%

“…However, as some researchers have suggested, psychological or motivational issues may be important factors in determining outcomes of educational interventions. 29 ' 30 Clearly, the careful evaluation of psychosocial interventions for improving diabetes self-care is a critical next step in research. Well-designed clinical trials are needed to assess different psychosocial techniques alone and in combination with educational approaches.…”

Section: " 28mentioning

confidence: 99%

Current Status of Psychosocial Research in Diabetes

Jacobson

1986

Diabetes Care

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A Randomized Study of the Effects of a Home Diabetes Education Program

Cited by 95 publications

References 0 publications

Effectiveness of Self-Management Training in Type 2 Diabetes

Effectiveness of Self-Management Training in Type 2 Diabetes

Education for secondary prevention of foot ulcers in people with diabetes: a randomised controlled trial

Current Status of Psychosocial Research in Diabetes

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