Evaluation of a T2DM Lifestyle Modification Counseling Program to Improve Patient Engagement in Diabetes Self-Care in a Community Mental Health Clinic

Abstract

Introduction: The prevalence of Type 2 diabetes mellitus (T2DM) is gradually increasing throughout the globe. An estimated 415 million adults worldwide have diabetes. It is estimated that another 318 million adults suffer from impaired glucose tolerance. By the year 2040, these numbers are expected to increase to 642 million and 482 million respectively. The disease is reaching pandemic proportions and represents a significant burden on the world population. The use of lifestyle modification counseling has been shown to statistical significant among patient with T2DM, however, diabetes still a major problem in develop and under develop country. The project aimed to increase patient engagement in care of T2DM in one community mental health center (CMHC). Participants included a convenience sample of mental health patients attending the CMHC. The theoretical framework for the project was the trans-theoretical model of quality improvement. Methods: This project utilized a descriptive survey design. A total of 73 patients participated in both the preand post-interventions. The average age was 59.36 (SD = 8.739) years old with the youngest participant being 40 years old and the most senior participant being 78 years old for an age range of 38 years. As seen in Table 1, the participants were mostly female (n = 52, 71.2%), Hispanic (n = 59, 80.8%) and were diagnosed with depression (n = 39, 53. 4%).Participating patients completed the Patient Activation Measure 13 (PAM13) at pre- and post- intervention intervals to assess individual attitudes and confidence related to the selfmanagement of their care. Analysis included chart audits to assess the effectiveness of the intervention and to address the feasibility of implementing a lifestyle modification counseling program. Results: Patients demonstrated significantly increased engagement in their care at the end of the twelve-week implementation period. The PAM13 survey results remained consistent, and patients felt confident in their ability to effectively continue engagement in their care. Patient engagement in T2DM care improved after lifestyle modification counseling. The potential to improve health care outcomes is evident when providers increase communication with patients. Such interventions may ultimately lead to lower overall health care costs. Conclusions: The results demonstrated that an increase in post-implementation lifestyle modification counseling helps patient engagement. The intervention was statistically significant and demonstrated that the introduction of a lifestyle modification counseling increased patient engagement.