Pro-Active Call Center Treatment Support (PACCTS) to Improve Glucose Control in Type 2 Diabetes

Young, Robert J.; Taylor, J Leahy; Friede, Tim; Hollis, Sally; Mason, James; Lee, Pauline; Burns, E.; Long, Andrew; Gambling, Tina; New, John P.; Gibson, J. M.

doi:10.2337/diacare.28.2.278

Cited by 92 publications

(101 citation statements)

References 19 publications

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“…Since no feedback whatever (acknowledgement, encouragement, intervention, education) was returned to the patient using the system, we suggest that this favourable drop may be attributed to a Hawthorne (placebo) effect caused by merely requiring patients to report their blood glucose values on a daily basis to a passive call centre. Young et al [20] achieved identical improvements in HbA 1 c in type 2 diabetes but using a personalised telephone care centre support system, known as the Pro-Active Call Center Treatment Support, which featured two telecarers supported by a diabetes nurse specialist. It is encouraging that when the predictions afforded by the engine are acted upon [5], large and significant reductions in the rates of hypoglycaemia and major improvements in glycaemic control can be realised.…”

Section: Discussionmentioning

confidence: 99%

Home blood glucose prediction: clinical feasibility and validation in islet cell transplantation candidates

et al. 2005

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Aims/hypothesis: Diabetic subjects do home monitoring to substantiate their success (or failure) in meeting blood glucose targets set by their providers. To succeed, patients require decision support, which, until now, has not included knowledge of future blood glucose levels or of hypoglycaemia. To remedy this, we devised a glucose prediction engine. This study validates its predictions. Methods: The prediction engine is a computer program that accesses a central database in which daily records of self-monitored blood glucose data and life-style parameters are stored. New data are captured by an interactive voice response server on-line 24 h a day, 7 days a week. Study subjects included 24 patients with debilitating hypoglycaemia (unawareness), which qualified them for islet cell transplantation. Comparison of each prediction with the actually observed data was done using a Clarke Error Grid (CEG). Patients and providers were blinded as to the predictions. Results: Prior to transplantation, a total of 31,878 blood glucose levels were reported by the study subjects. Some 31,353 blood glucose predictions were made by the engine on a total of 8,733 days-used. Of these, 79.4% were in the clinically acceptable Zones of the CEG. Of 728 observed episodes of hypoglycaemia, 384 were predicted. After transplantation, a total of 45,529 glucose measurements were reported on a total of 12,906 days-used. Some 42,316 glucose predictions were made, of which 97.5% were in the acceptable CEG Zones A and B. Successful transplantation eliminated hypoglycaemia, improved glycaemic control, lowered HbA 1 c and freed 10 of 24 patients from daily insulin therapy. Conclusions/ interpretation: It is clinically feasible to generate valid predictions of future blood glucose levels. Prediction accuracy is related to glycaemic stability. Risk of hypoglycaemia can be predicted. Such knowledge may be useful in self-management.

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Section: Discussionmentioning

confidence: 99%

Home blood glucose prediction: clinical feasibility and validation in islet cell transplantation candidates

et al. 2005

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“…There was an example of a negative impact of linkages: the PACCTS study used information from the patients' e-health records to trigger telephone calls. 40 Patients would visit their GP and have HbA1c tests and if the results were above 9% they received a monthly call and this reduced to three monthly if HbA1c was 7%. Patients may not have been aware that this information had triggered the telephone calls and 8.2% withdrew because they could not cope with the calls.…”

Section: Discussionmentioning

confidence: 99%

“…Only one 46 of seven studies using planned coaching reported improvements in adherence compared with 4/4 using reactive coaching. 21,33,35,[38][39][40] …”

Section: Improvements In Behaviour Self-efficacy and Health Statusmentioning

confidence: 99%

“…weekly or monthly telephone calls to support the patients with chronic disease; n = 25) and only five studies described reactive coaching (see Table 4). 21,[29][30][31][32][33][34][35][36][37][38][39][40] Reactive coaching (responding to data uploaded by participants) tended to focus on patients categorised as being at level 2 who were engaged in active disease management such as symptom monitoring and SM. The majority of the telephone coaching interventions (n = 23) targeted patients categorised as being at level 2 or level 3 of the KPRP, i.e.…”

Section: Design Of the Telephone Coaching Interventionmentioning

confidence: 99%

“…In the pro-active call centre treatment support (PACCTS) trial in the UK, 31,40 acceptability was measured by a purposely designed questionnaire and was administered to the intervention group after the patient had received at least three proactive calls. Ninety percent of participants agreed that PACCTS was an acceptable intervention.…”

Section: Important Components Of Telephone Coachingmentioning

confidence: 99%

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Do people with existing chronic conditions benefit from telephone coaching? A rapid review

Dennis

Harris

Lloyd

et al. 2013

Aust. Health Review

102

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Objective. To examine the effectiveness of telephone-based coaching services for the management of patients with chronic diseases.Methods. A rapid scoping review of the published peer reviewed literature, using Medline, Embase, CINAHL, PsychNet and Scopus. We included studies involving people aged 18 years or over with one or more of the following chronic conditions: type 2 diabetes, congestive cardiac failure, coronary artery disease, chronic obstructive pulmonary disease and hypertension. Patients were identified as having multi-morbidity if they had an index chronic condition plus one or more other chronic condition. To be included in this review, the telephone coaching had to involve two-way conversations by telephone or video phone between a patient and a provider. Behaviour change, goal setting and empowerment are essential features of coaching.Results. The review found 1756 papers, which was reduced to 30 after screening and relevance checks. Most coaching services were planned, as opposed to reactive, and targeted patients with complex needs who had one or more chronic disease. Several studies reported improvements in health behaviour, self-efficacy, health status and satisfaction with the service. More than one-third of the papers targeted vulnerable people and telephone coaching was found to be effective for these people.Conclusions. Telephone coaching for people with chronic conditions can improve health behaviour, self-efficacy and health status. This is especially true for vulnerable populations who had difficulty accessing health services. There is less evidence for improvements in quality of life and patient satisfaction with the service. The evidence for improvements in health service use was limited. This rapid scoping review found that telephone-based coaching can enhance the management of chronic disease, especially for vulnerable groups. Further work is needed to identify what models of telephone coaching are most effective according to patients' level of risk and co-morbidity. What is known about the topic?With the increasing prevalence of chronic diseases more demands are being made of limited health services and resources. Telephone health coaching for people with or at risk of chronic diseases is seen as a means of supporting people to manage their health and reducing the burden on the healthcare system. What does this paper add? Telephone coaching interventions were effective for vulnerable people with chronic disease (s). Often the vulnerable populations had worse control of their chronic condition at baseline and demonstrated the greatest improvement compared with those with better control at baseline. Planned (i.e. weekly or monthly telephone calls to support the patients with chronic disease) and unscripted telephone coaching interventions appear to be most effective for improving self-management skills in people from vulnerable groups: the planned telephone coaching services had the advantage of regular contact and helping people develop their skills over time, whereas the u...

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Evaluation of a Behavior Support Intervention for Patients With Poorly Controlled Diabetes

Frosch

Uy²,

Ochoa³

et al. 2011

Arch Intern Med

112

177

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Pro-Active Call Center Treatment Support (PACCTS) to Improve Glucose Control in Type 2 Diabetes

Cited by 92 publications

References 19 publications

Home blood glucose prediction: clinical feasibility and validation in islet cell transplantation candidates

Home blood glucose prediction: clinical feasibility and validation in islet cell transplantation candidates

Do people with existing chronic conditions benefit from telephone coaching? A rapid review

Evaluation of a Behavior Support Intervention for Patients With Poorly Controlled Diabetes

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