Efficacy of a self-management education programme on patients with type 2 diabetes in primary care: A randomised controlled trial

• Published in: Primary care diabetes Vol. 13; no. 2; pp. 122 - 133
• Main Authors: Gamboa Moreno, Estibaliz, Mateo-Abad, Maider, Ochoa de Retana García, Lourdes, Vrotsou, Kalliopi, del Campo Pena, Emma, Sánchez Perez, Álvaro, Martínez Carazo, Catalina, Arbonies Ortiz, Juan Carlos, Rúa Portu, M. Ángeles, Piñera Elorriaga, Koldo, Zenarutzabeitia Pikatza, Amaya, Urquiza Bengoa, Miren Nekane, Méndez Sanpedro, Tomás, Oses Portu, Ana, Aguirre Sorondo, Miren Bakarne, Rotaeche del Campo, Rafael
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-04-2019
• Subjects: Aged; Biomarkers - blood; Blood Glucose - drug effects; Blood Glucose - metabolism; Chronic disease; Diabetes Mellitus type 2; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; Education; Female; Glycated Hemoglobin A - metabolism; Health Behavior; Health Communication; Health Knowledge, Attitudes, Practice; Humans; Hypoglycemic Agents - therapeutic use; Male; Medication Adherence; Middle Aged; Patient Education as Topic - methods; Patient Satisfaction; Peer Group; Peer-support; Primary care; Primary Health Care; Quality of Life; Risk Reduction Behavior; Self-management; Self-Management - methods; Spain; Time Factors; Treatment Outcome; Spain; Self-management; Peer-support; Chronic disease; Education; Diabetes Mellitus type 2; Primary care
• ISSN: 1751-9918; 1878-0210
• DOI: 10.1016/j.pcd.2018.10.001

•Peer-support face-to-face self-management programmes can benefit T2DM patients.•Particularly disease control self-efficacy skills can improve usual care results.•Interventions like SDSMP, boosting such skills, are efficacious in our setting.•This experience can help improving other chronic pathologies’ self-management.
The purpose of this study was to assess the efficacy of the Spanish Diabetes Self-Management Program (SDSMP) versus usual care in adults with type 2 diabetes mellitus (T2DM) residing in a Spanish region.
A two-year follow-up randomised controlled trial. The intervention consisted of 6 weekly structured peer-to-peer workshops. The primary outcome was change in HbA1c levels. Secondary outcomes included other clinical measures, quality of life, self-efficacy, life-style changes, medication and use of healthcare services. Mixed effect models were fitted.
n=297 patients were recruited in each study arm. Baseline HbA1c levels were comparable in both groups with an overall mean 7.1 (SD=1.2). The intervention did not significantly modify HbA1c, or other cardiovascular variables. Significant improvements were seen in self-efficacy, and in particularly its disease control component. Certain differences were also observed in the use of healthcare resources and medication consumption. High workshop participation and satisfaction rates were achieved.
HbA1c reductions are difficult to obtain in adequately controlled patients. On the other hand, raising awareness on one’s disease can increase disease control self-efficacy. This finding, accompanied by reduced medication consumption and healthcare use rates, highlights that usual care would be benefited by incorporating certain SDSMP aspects.
Trial registration: ClinicalTrials.gov identifier NCT01642394