Impact of patient‐centred diabetes self‐management education targeting people with type 2 diabetes: an integrative review

Olesen, Kasper; Hempler, Nana Folmann; Drejer, Sabina; Baumgarten, Sabine; Stenov, Vibeke

doi:10.1111/dme.14284

Cited by 25 publications

(35 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The selection of measurement instruments was guided by a recent review of psychometric tools for diabetes education services (19). The review investigated instruments to measure commonly targeted outcomes of diabetes education.…”

Section: Participatory Approachmentioning

confidence: 99%

The Design of an Evaluation Framework for Diabetes Self-Management Education and Support Programs Delivered Nationally

Olson¹,

White²,

Mitchell³

et al. 2021

Preprint

View full text Add to dashboard Cite

Background The aim of this work was to develop a National Evaluation Framework to facilitate the standardization of delivery, quality, reporting, and evaluation of diabetes education and support programs delivered throughout Australia through the National Diabetes Services Scheme (NDSS). The NDSS is funded by the Australian Government, and provides access to diabetes information, education, support, and subsidized product across diverse settings in each state and territory of Australia through seven independent service-providers. This article reports the approach undertaken to develop the Framework. Methods A participatory approach was undertaken, focused on adopting nationally consistent outcomes and indicators, nominating objectives and measurement tools, specifying evaluation processes, and developing quality standards. Existing programs were classified based on related, overarching indicators enabling the adoption of a tiered system of evaluation. Results Two outcomes (i.e., improved clinical, reduced cost) and four indicators (i.e., improved knowledge and understanding, self-management, self-determination, psychosocial adjustment) were adopted from the Eigenmann and Colagiuri national consensus position statement for diabetes education. This allowed for the identification of objectives (i.e., improved empowerment, reduced distress, autonomy supportive program delivery, consumer satisfaction) and related measurement instruments. Programs were categorized as comprehensive, topic-specific, or basic education, with comprehensive programs allocated to receive the highest-level of evaluation. Twelve quality standards were developed, with existing programs tested against those standards. Based on the results of testing, two comprehensive (OzDAFNE for people with type 1 diabetes, DESMOND for people with type 2 diabetes), and eight topic-specific (CarbSmart, ShopSmart, MonitorSmart, FootSmart, MedSmart, Living with Insulin, Insulin Pump Workshop, Ready Set Go – Let’s Move) structured diabetes self-management education and support programs were nominated for national delivery. Conclusions The National Evaluation Framework has facilitated consistency of program quality, delivery, and evaluation of programs delivered by multiple service providers across diverse contexts. The Framework could be applied by other service providers who facilitate multiple diabetes education and support programs and could be adapted for use in other chronic disease populations where education and support are indicated.

show abstract

Section: Participatory Approachmentioning

confidence: 99%

The Design of an Evaluation Framework for Diabetes Self-Management Education and Support Programs Delivered Nationally

Olson¹,

White²,

Mitchell³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Although person-centered approaches, professional skills training and personal goal setting have been suggested as effective ingredients to facilitate diabetes self-management education and support,10 it is not clear whether person-centered diabetes care improves peoples’ engagement.…”

Section: Introductionmentioning

confidence: 99%

Person-centered diabetes care and patient activation in people with type 2 diabetes

Rutten

Vugt

Koning

2020

BMJ Open Diab Res Care

View full text Add to dashboard Cite

IntroductionThe American Diabetes Association and the European Association for the Study of Diabetes advocate a person-centered approach to enhance patient engagement in self-care activities. To that purpose, people with diabetes need adequate diabetes knowledge, motivation, skills and confidence. These prerequisites are captured by the concept ‘patient activation’. The Dutch Diabetes Federation implemented a person-centered consultation model for the annual diabetes review. To assess its relationship with patient activation, we measured the change in patient activation, and in person and disease-related factors in people with type 2 diabetes after their second person-centered annual review.Research design and methodsObservational study in 47 primary care practices and six outpatient hospital clinics. Follow-up: 1 year. From 2.617 people with diabetes and capable of completing questionnaires (no additional exclusion criteria) 1.487 (56.8%) participated, 1366 with type 2 diabetes. Main outcome: patient activation (13-item Patient Activation Measure, score 0–100). Before the first and after the second review, participants completed questionnaires. Medical data were retrieved from electronic records. We performed a repeated measure analysis using a linear mixed model in 1299 participants, who completed the first set of questionnaires.ResultsIn 1299 participants (41.6% female, mean age 66 years, median diabetes duration 10 years, median glycated hemoglobin (HbA1c) 6.8%/51 mmol/mol), the mean baseline activation level was 58.9 (SD 11.7). Independent of actual diabetes care, activation levels increased 1.53 units (95% CI 0.67 to 2.39, p=0.001). Several diabetes perceptions improved significantly; diabetes distress level decreased significantly. Body mass index (−0.22, 95% CI −0.33 to −0.10, p<0.001) and low-density lipoprotein cholesterol (−2.71 mg/dL, 95% CI −4.64 to −0.77, p=0.004) decreased, HbA1c increased 0.08% (95% CI 0.03 to 0.12) (p=0.001).ConclusionsPerson-centered diabetes care was associated with a slightly higher patient activation level, improved diabetes perception and small improvements in clinical outcomes. Person-centered care may enhance patient engagement, but one should not expect substantial improvement in patient outcomes in the short term.

show abstract

“…The theoretical perspective of person-centered care is a key attribute in chronic disease management (BC Ministry of Health, 2015c;Canadian Academy of Health Sciences, 2017). Yet, despite a person-centred approach being well described in health care literature, the paradigm shift from a paternalistic medical model where the patient is a passive recipient of care to an empowered active participant continues to evolves and requires deliberate inclusion when reorganizing health services (Olesen et al, 2020;Pulvirenti et al, 2014). Person-centered care is described by Epstein and Street (2011) as a "quality of personal, professional, and organizational relationships" (p 100) that requires care to be centered around the person, their families, clinicians and health systems.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

“…Therefore, there is a need to overtly acknowledge adopting a person-centered approach to avoid system or provider focused models of care. This creates the opportunity for improved patient care experiences and improved chronic disease management (Olesen et al, 2020;World Health Organization, 2016a).…”

Section: Theoretical Frameworkmentioning

confidence: 99%

“…Self-management education and support is a critical component of diabetes management (Sherifali et al, 2018). It is a prevalent theme in the majority of literature on chronic disease management and diabetes care, and highlighted in the Chronic Care Model (Barr et al, 2003;Grover & Joshi, 2015;Olesen et al, 2020;Penn et al, 2015;Reynolds et al, 2018;. Self-management is a complex concept.…”

Section: Self-managementmentioning

confidence: 99%

See 1 more Smart Citation

Narrative literature review and gap analysis of diabetes services in a community setting

Shaw¹

View full text Add to dashboard Cite

The goal of this project was to outline best practices regarding the organization of diabetes care and services in the community in relation to the local context of services in Squamish, BC, Canada to create a foundation for future quality improvement work. The theoretical framework of personcentered care is essential to chronic disease management and underpins this work. The methods include: 1) A narrative literature review consisting of a database search, and 2) A gap analysis consisting of local data and an environmental scan. The Chronic Care Model is an evidence-based integrated care framework used to organize the findings of the narrative literature review and the gap analysis and to frame the recommendations (Clement et al., 2018). Based on the findings, evidence-based recommendations were created specific to the context of diabetes care in Squamish, BC creating the opportunity for meaningful future quality improvement work.

show abstract

Impact of patient‐centred diabetes self‐management education targeting people with type 2 diabetes: an integrative review

Cited by 25 publications

References 51 publications

The Design of an Evaluation Framework for Diabetes Self-Management Education and Support Programs Delivered Nationally

The Design of an Evaluation Framework for Diabetes Self-Management Education and Support Programs Delivered Nationally

Person-centered diabetes care and patient activation in people with type 2 diabetes

Narrative literature review and gap analysis of diabetes services in a community setting

Contact Info

Product

Resources

About