Diabetes to Go: Knowledge- and Competency-Based Hospital Survival Skills Diabetes Education Program Improves Postdischarge Medication Adherence

Abstract

The primary purpose of this study was to demonstrate the feasibility of providing inpatient knowledge-based diabetes "survival skills" education. In addition, the preliminary impact of the survival skills education intervention on medication adherence and hospital plus emergency department admissions was assessed. This study was a prospective nonrandomized pilot study conducted in an urban teaching hospital. In sum 125 adults consented-the majority of whom were African American women-with uncontrolled diabetes: blood glucose > 200 mg/dL or < 40 mg/dL upon admission to general medicine units. Mean admitting blood glucose was 283 ± 128 mg/dL. Evaluation measures were diabetes knowledge, medication adherence, and hospital admissions plus emergency department visits at and/or 3 months before baseline and at 2 weeks and 3 months postdischarge. There was improvement in diabetes knowledge and medication adherence, which was sustained to 3 months. A trend was observed toward reduction in emergency department and/or hospital admissions from 3 months preintervention to 3 months postdischarge for uncontrolled diabetes. This knowledge-based program successfully provided survival skills education to hospital patients with uncontrolled diabetes and demonstrated preliminary evidence of a positive impact on medication adherence and a trend toward reduction in hospital and emergency department admissions.