Abstract
BackgroundMany self-management programs have been developed so far. Their effectiveness varies. The program ‘Beyond Good Intentions’ (BGI) is based on proactive coping and has proven to be (cost-) effective in achieving reductions in BMI and blood pressure in screen-detected type 2 diabetes patients up until nine months follow-up. However, its long-term effectiveness in people already known with diabetes is lacking. In addition, its (cost-) effectiveness might increase if people who are likely not to be benefit from the program are excluded in a valid way. Therefore it was aimed to investigate the long-term effects of the educational program BGI on cardiovascular risk, quality of life and diabetes self-management behaviour in a pre-selected group of patients known with type 2 diabetes up to 5 years.MethodsRandomised controlled trial with 2.5 year follow-up. Adults (≤75 years) with a type 2 diabetes duration between 3 months and 5 years will be included. With the use of a self-management screening tool (SeMaS) their potential barriers of self-management due to depression and/or anxiety will be determined. Based on the results of the SeMaS selection patients will be randomised (1:1) to the BGI-group (n = 53) or the control-group (n = 53). In addition to receiving usual care, patients in the BGI-group will follow the 12-week theory-based self-management program and a booster session a few months thereafter. The control-group will receive care as usual. The primary outcome is change in Body Mass Index after 2.5 years follow-up. Secondary outcomes are HbA1c, lipid profile and systolic blood pressure, (diabetes) quality of life, level of physical activity, dietary intake and medication adherence and proactive coping. Cost-effectiveness will be based on total use of health care resources during the entire study period. Difference between groups in change over time will be analysed according to intention-to-treat analysis.ConclusionsBy differentiating between patients who will and those who are likely not to benefit from the educational program, a more (cost-) effective self-management program might be designed, also on the long-run. Trial registration NTR 5330
Highlights
Many self-management programs have been developed so far
We developed the Beyond Good Intentions (BGI) program to enhance the ability of patients to
Beyond Good Intentions’ (BGI) has proven to be effective in patients with screen-detected type 2 diabetes mellitus (T2DM) up until 9 months follow-up [2]
Summary
Many self-management programs have been developed so far. Their effectiveness varies. The program ‘Beyond Good Intentions’ (BGI) is based on proactive coping and has proven to be (cost-) effective in achieving reductions in BMI and blood pressure in screen-detected type 2 diabetes patients up until nine months follow-up. Vos et al Diabetol Metab Syndr (2016) 8:82 act upon their intentions It is based on the theories of self-regulation and proactive coping [1], assuming that people should control and direct their actions in order to meet their goals. Based on a computer-based simulation model to project long-term health benefits and cost-effectiveness, BGI was among the four diabetes self-management programs worldwide, with a minimum follow-up of 12 months, with the best cost-effectiveness ratio [3]. Real, not modelled, long-term data on (cost-) effectiveness of BGI are lacking and its effectiveness in people who are known with T2DM and not screen-detected, is unclear
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