Self-management Training Program Research Articles

A Case Report on Examining the Effectiveness of a Self-Management Training Program for Adolescents at High Risk of Smartphone Addiction

A Case Report on Examining the Effectiveness of a Self-Management Training Program for Adolescents at High Risk of Smartphone Addiction

Effect of a 5A Model-based Self-management Program on Self-management Ability and Dyspnea Severity in the Elderly with Chronic Heart Failure: A Randomized Clinical Trial

Objectives Heart failure is one of the common chronic diseases in old age and is considered as a progressive and debilitating disorder. Nowadays, the use of supportive and non-pharmacological methods in disease management and empowerment of elderly patients is of increasing importance. This study was aims to assess the effect of a 5A model-based self-management program on self-management ability and dyspnea severity in the elderly with chronic heart failure. Methods & Materials This is a randomized controlled clinical trial that was conducted on 75 eligible elderly people with heart failure (Class II or III) in Babol, Iran. They were randomly divided into two groups of intervention and control. The intervention group received the self-management training program based on the 5A model for 12 weeks. The control group received the usual training. The data before and immediately after the intervention were collected using the self-management ability scale (SMAS) and the five-item modified Medical Research Council (MMRC) dyspnea scale. The collected data was analyzed in SPSS software version 24. Results The mean age of patients was 68.026±3.956 in the intervention group and 69.595±4.079 in the control group. There were no statistically significant differences between the two groups in terms of demographic and clinical characteristics. After the intervention, the total SMAS score and severity of dyspnea in the intervention group were significantly higher than in the control group (P<0.001). The difference was also significant in all subscales of SMAS between the two groups (P<0.001). Conclusion Considering the positive effect of the 5A model-based self-management program on improving self-management ability and reducing the severity of dyspnea in the elderly with chronic heart failure, it can be used as a simple, low-cost, effective method, without the need to go to medical centers, to improve the quality of life of these patients.

Utilization of diabetes self-management program among breast, prostate, and colorectal cancer survivors: Using 2006-2019 Texas Medicare data.

Cancer treatment is associated with inferior health outcomes such as diabetes. Medicare provides Diabetes Self-Management Training (DSMT) program to beneficiaries to achieve normal metabolic control and reduce the risk of micro and macro-vascular complications. This study aimed to examine the trend of DSMT utilization among cancer survivors and assess individual characteristics associated with it. The data for this study was from Texas Cancer Registry-Medicare linkage data of patients with prostate, breast, or colorectal cancer diagnosed in 1999-2017. Outcome variables include the number of first-time DSMT users, the number of total users, and the average number of DSMT utilization in minutes. We performed logistic regression and gamma regression to obtain a multivariable-adjusted odds ratio for the association between DSMT utilization and individual characteristics. The number of first-time users has slowly increased over the years (from 99 to 769 per 1,000) but suddenly dropped after 2016. The number of all users (first-time and follow-up users) has increased (from 123 to 1,201 per 1,000) and plateaued after 2016. Determinants including Hispanic ethnicity (O.R. = 1.10) and Medicare-Medicaid dual eligibility (O.R. = 1.25) are positively associated with both the initiation and retention of the DSMT. A barrier to both initiation and retention of DSMT is living in a metropolitan area (O.R. = 0.90). Multi-level strategies to enhance accessibility and availability of DSMT programs for Medicare beneficiaries are highly recommended. Examining the determinants of initiation and retention of DSMT over 14 years provides insights on strategies to meet the needs of cancer survivors and reduce the burden of diabetes on them.

Self-management training in patients with chronic kidney disease undergoing hemodialysis: A systematic review.

The aim of this systematic review is to investigate the effectiveness of different self-management training programs applied to dialysis patients. During the literature review, the flow chart of preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) was utilized. The review was limited by the year. All studies in English were screened in the databases "Ulakbim National Database, Google Scholar, Scopus, PubMed, Science Direct, Web of Science, Medline, EBSCOhost, and Cochrane Library." Eleven studies, including nine randomized controlled and two quasi-experimental, were included in the review.

Adapting to the burdens of care: a telehealth program for cancer survivors with ostomies.

An ostomy introduces to cancer survivors new demands for self-care and healthcare resource use. A curriculum that teaches ostomates self-management skills may affect survivors' use of resources. A prospective randomized trial comparing usual care (UC) with an Ostomy Self-Management Training (OSMT) program delivered by telehealth was conducted in patients with ostomies due to cancer. The intervention occurred over 5weeks with survey administration at baseline, program completion, and 6months after completion. Quantitative data were analyzed using a mixed-effects logistic model to predict mean values of resource and service use. Responses to the open-ended question were coded and analyzed with directed content analysis. One hundred and sixty-seven subjects (89 in the OSMT arm and 78 in the UC arm) completed the questionnaire at all time points. The changes in likelihoods of emptying one's ostomy bag > 8 times/week and of incurring any out-of-pocket costs on accessories were 14% greater for the intervention group (p = .029 and p = .063, respectively). Qualitative analysis reveals among the OSMT arm an increase in the proportion of ostomy-specific comments and a decrease in the same metric among the UC arm. Common themes included learning to work with equipment, dealing with gas build-up and finding well-fitting clothing. There are some indications that participants in this structured telehealth program are more active in ostomy self-care. The reported ostomy self-care activities, healthcare consumables, and healthcare services reported by both groups illustrate the complexity of survivorship care following ostomy surgery. National Clinical Trial Identifier: NCT02974634.

Development of a home health care service platform for ostomy patient management.

The use of an ostomy for urination and defecation leads to reduced quality of life. Although many ostomy management strategies are needed, such strategies are often implemented by patients. Thus, there is a need for a home health care service platform that can be used in ostomy patient management. We developed an ostomy patient management platform by identifying the needs of patients and medical staff through the Chronic Care Ostomy Self-Management Training Program in the United States and from studies conducted in Korea. The platform encompassed physical management, psychological management, maintenance of social function, spiritual stability, and home medical care. These components were implemented through monitoring, self-care guidance, and a community platform. For the monitoring function, patients entered their health status in a mobile application (app); the medical staff at the affiliated hospital then monitored the stoma status through a web interface. Our platform allows medical staff to monitor ostomy patients through a web interface and help such patients to fully manage their ostomy at home using an app. We expect that the continued development of patient-oriented functions in our app will allow ostomy patients to experience quality-of-life improvements.

The effect of cognitive performance on self-management behavior of multiple sclerosis patients

BackgroundDifficulties of self-management in people with MS (pwMS) is considered as one of the most important factors contributing to low rehabilitation efficacy, more severe long-term complications and increase in healthcare costs. Despite the emergence of research in the last decade documenting causes, types, and course of cognitive difficulties in MS disease subtypes, limited evidence is available in the literature for direct comparison of self-management and cognitive deficits. In this study we aimed to investigate the relationship between cognitive performance and self-management in pwMS. MethodsPwMS who applied to neurology out-patient clinics of seven different centers were included into study. Multiple Sclerosis Self-Management Scale- Revised (MSSM-R) was used for the assessment of self-management behaviors and Multiple Sclerosis inventory cognition scale (MUSIC) was used for the assessment of cognitive performance and fatigue. ResultsIn this study, 194 (144 female and 50 male) pwMS participated (mean age = 38.9 years). The course of the disease was RRMS in 173 patients and mean EDSS was 2.0. 68.5% of the participants were married, 32.5% were employed, and 57.2% had secondary education. The MSSM-R mean score of the study group was 42.6 ± 10.4 (1–81). There was a positive correlation between MSSM-R and MUSIC-cog scores (r = 0.21, p = 0.003). A hierarchical multiple regression revealed that income level (β = 0.196, t = 2.692, p = 0.008) and cognitive performance (β = 0.167, t = 2.063, p = 0.041) together with control variables (gender, age, educational status, employment status, duration of disease, EDSS and fatigue) explained 5.5% of the variance in self-management. ConclusionCognitive performance is a predictor of self-management in pwMS. Better self-management behavior is also related with employment and income level in pwMS. Studies evaluating patients' cognitive abilities and evaluating the effectiveness of adapted self-management training programs are needed.

Self-management goals of cancer survivors with an ostomy.

Ostomies due to cancer surgery impose complex and enduring care challenges that necessitate cancer survivors" self-management. The objective of this analysis is to evaluate ostomates' self- management goals using a qualitative approach. A multi-site randomized controlled trial testing the Ostomy Self-Management Training program (OSMT) was delivered via telehealth to a group of cancer survivors with an ostomy randomized to either the OSMT program with goal setting or usual care (UC), without goal setting. Goals were classified by type and frequency according to a modified City of Hope Health-Related Quality of Life framework (physical, psychological, social, spiritual, ostomy-specific, and healthcare quality domains), using a directed and systematic content analysis approach. The 524 self-management goals analyzed by domain frequencies physical (29.4%), ostomy specific (29.0%) and social well-being (25.0%) were predominant. Managing other health issues (7.6%), psychological issues (6.0%), and spiritual well-being issues (3.0%) were next. Common self-management themes were ostomy care independence (87.5%), handling cancer-related issues (62.5%), achieving acceptance (56.2%), resuming physical activity (43.0%), and maintaining fluid/diet balance (43.0%). Goal-setting offers insights into self-management concerns of cancer survivors with ostomies. Results demonstrate the broad aspects of self-management ostomates face. Self-management training with patient goal-setting may be used to help ostomates with cancer and their health care providers identify areas for needed education and support.

Effects of the self-management training program on self-management behavior and blood pressure levels among elderly people with hypertension

Abstract Objective To determine the effects of the Self-Management Training Program on self-management behavior and blood pressure (BP) levels among elderly people with hypertension (HT). Methods This study was based on a quasi-experimental design using sampling groups composed of elderly residents of Pathum Thani Province with HT. Simple random sampling was applied to two sampling groups, an experimental group and a control group. However, the experimental group had been on the Self-Management Training Program based on the Creer concept. The Program's contents included small-group health-education sessions and the patients’ manual, Self-Management Training Skills for Self-Management Behavior. Small group discussions were held for self-reflection, to stimulate follow-up for self-management behavior training during home visits. The Self-Management Training Program was compared with programs involving the more usual care. Data were collected using the Self-Management Behavior for Hypertension Control Questionnaire and BP assessment tests. Data were analyzed using a descriptive statistic, chi-square test, pair t-test, repeated-measures Analysis of Variance (ANOVA), and repeated-measures Analysis Covariance (ANCOVA). Results It was found that at 13 weeks after entering the program, the experimental group demonstrated a significantly lower systolic and diastolic BP with a baseline statistical significance (P < 0.005), and that at the 4th week and the 13th week, there was a decrease in BP in the experimental group. The experimental group also had above-baseline self-management behavior scores that were higher than in the control group (P < 0.01). Conclusions Results from this study show that the Self-Management Program was useful for BP control and promoted sustainable self-management behavior.

Take time to listen: community health worker perceptions on self-management trainer role

ABSTRACT This study examines the effectiveness of self-management training with emphasis on trainer traits. Twenty-two community health workers (CHWs) participated in a two week-long self-management training program. Twenty were interviewed a week later to examine their perceptions of the training and the trainer. Participants expressed satisfaction with the training and highlighted four themes around how trainers must play a transformational role grounded in cultural humility: intentional relationship building, commitment to ongoing learning and transfer of knowledge, participatory engagement, and empowerment. CHW self-management trainers who are culturally attuned with participants’ backgrounds stand a better chance of conducting training that is sensitive to the needs of CHWs and their clients.

Impacts on patient-centered outcomes of a chronic pain self-management program in a rural community: A feasibility study

This study explored if a self-management training program was feasible for a predominantly older rural Latino adults with chronic pain who had limited access to non-pharmacologically based pain treatment. Physical therapy doctoral students delivered the six-week low-literacy low-cost patient-centered program. The intervention was feasible to the participants (n=38) who showed improvement in a majority of the eight outcome measures at 6-week posttest and three measures at 18-week followup. The changes in pain severity, pain interference and pain-related physical functions reached minimally clinically important difference at follow-up. A randomized controlled trial with long-term follow-up is needed to test the program effectiveness in partnership with community health centers to increase access to pain management in rural communities.

A Theory-Based Self-Management Training Program for Older Adult Peer Leaders with Diabetes: A Feasibility Assessment.

ObjectiveTo improve the quality of peer leader training, this study developed a theory-based self-management training program for older adult peer leaders with diabetes and assessed its feasibility.BackgroundCurrent self-management programs are designed mainly to be implemented by healthcare professionals, but healthcare staff may not fully perceive the needs and obstacles of older adults in disease management due to a lack of similar illness experience. To target this problem, peer leaders with successful self-management experiences, similar cultural backgrounds and languages, and related illness experiences are trained to guide and mentor peer patients in self-management programs.Study Design and MethodsThis study was conducted in two stages. In stage 1, a peer leader training program was developed based on experiential learning theory as the framework and self-regulation theory as the activity design strategy. In stage 2, program feasibility was assessed via participants’ feedback toward the training program by three indicators: attendance, future willingness to lead the peer-led self-management program, and leadership skills evaluated by a peer leader training assessment tool.ResultsIn this study, peer leaders demonstrated good leadership skills by expressing active willingness to lead self-management programs in the community. Peer leaders’ feedback indicated that the program’s training content was helpful in preparing peer leaders to guide older adults in learning self-management skills and in improving the abilities and confidence of peer leaders in mentoring self-management.ConclusionFindings in this study showed that peer leader training can impact the effectiveness and success of self-management in older adults with diabetes. Even in a small-scale study, the impact was evident, which demonstrated the feasibility of the program. More large-scale studies on the effectiveness of various peer leader training programs in diverse disciplines are recommended.Clinical Trials RegistryClinicalTrials.gov Identifier: NCT04298424 (the Peer-Led Self-Management Program).

Self-management program for adolescents with chronic kidney disease: A randomized controlled trial.

It is important to develop self-management behaviours in adolescents to prevent chronic kidney disease progression. This study evaluates the effect of a self-management program that was developed based on individual and family self-management theory to aid adolescents with chronic kidney disease in the acquisition of competencies in the management of their disease. This is a randomized controlled study. The study was conducted with 20 intervention and 20 control patients, who were treated at two hospitals in Ankara between December 2018 and May 2019. Self-Management Assessment Form, Paediatric Quality of Life Inventory-Adolescent Form and clinical parameters. A training program, specific to chronic kidney disease, was administered over three sessions in a group training setting when the patients came to the clinic for follow-up. After the training program was completed, the patients were monitored for three months through home visits once every two weeks, totalling six visits. Following the application of self-management training, a statistically significant difference was found self-management knowledge and behaviours, quality of life and anxiety mean scores of intervention and control group (p <.05), a significant decrease in only blood urea nitrogen among the clinical parameters when compared to the control group. In this study, a self-management training program was developed based on Individual and Family Self-Management Theory, aiming to have a positive effect on the self-management behaviours of adolescents in the cognitive and psychosocial domains.

The effect of STARS for students with high incidence disabilities: a randomized pilot study

There is a need for more research on selective or Tier 2 interventions to support students with challenging classroom behaviors. Existing Tier 2 interventions lack effective mechanisms such as autonomy support, which are shown to improve student-teacher relations and build competencies in the form of social or intra and interpersonal skills. The purpose of the present exploratory study is to describe study findings of a selective intervention called the Self-management Training And Regulation Strategy (STARS). STARS is an autonomy supportive self-management or self-monitoring training program that promotes relationship and social competency skills which are linked to reductions in challenging classroom behavior. The present exploratory study includes data from a subset of 37 students with high incidence disabilities who participated in a larger study that involved 22 fourth and fifth grade classrooms using a randomized controlled design. Key outcomes of interest included teacher-rated social skills, sociability, learning behavior, and peaceful interactions. Fidelity and social acceptability of implementation were also monitored. Descriptive statistics and analysis of variance revealed that students randomized to STARS had improved sociability and teachers and students rated the intervention—applied with a high degree of fidelity—as highly acceptable and feasible.

Some reasons to stay energized during uncertain times

Over the last few weeks, there have been some sensational developments for pharmacists and our patients. I hope you’re as excited about them as I am. At the end of July, President Trump signed an executive order resurrecting a rule that could force PBMs to pass on to Medicare Part D beneficiaries any discounts from manufacturer rebates and other price concessions at point of sale. It was a rare L for PBMs, and it’s a positive sign that the executive branch recognizes that PBMs do not make drugs more affordable to patients—yet it’s not quite a W for us. Now, our job is to work with the U.S. Department of Health and Human Services (HHS) and our pharmacy partners to ensure the agencies implementing the rebate rule also end PBMs’ gaming of Medicare regulation loopholes that allows them to inflate patients’ prescription-drug costs and put pharmacies on life support by extracting vampiric direct and indirect remuneration (DIR) fees—not just retroactively, but once and for all. A few weeks later, CMS issued updated guidance granting new flexibility for accredited and recognized diabetes self-management training (DSMT) programs already billing Medicare Part B for DSMT services. These programs, CMS said, may furnish and bill for DSMT services provided via telehealth during the COVID-19 public health emergency. This is a huge triumph for diabetes care and education specialists and the Medicare beneficiaries with diabetes whom they serve. Then HHS announced it would authorize licensed pharmacists to provide all vaccines recommended by CDC’s Advisory Committee on Immunization Practices and approved or licensed by FDA to all children ages 3 to 18 during the COVID-19 pandemic, regardless of state laws and regulations to the contrary. This is great news. APhA has long advocated that pharmacists are uniquely positioned to address this public health emergency, and we worked with HHS to develop this strategy to engage all pharmacists. As Admiral Brett Giroir, the HHS assistant secretary for health, said in the announcement, pharmacists have always been a trusted voice in the community, and they’re readily accessible. We couldn’t agree more. We’ve still got some milestones to reach. Congress must include coverage for pharmacists’ COVID-19 and flu testing and immunizing services under Medicare Part B in the next coronavirus stimulus package. Keep writing and calling Capitol Hill to tell your patients’ stories and how much more pharmacists could be doing to help them stay safe and healthy, during the public health crisis and beyond. We aren’t done, but I’m thrilled with the progress we’re making and more optimistic than ever about pharmacy’s future. Let’s get there together!

N10 Effectiveness of self-management workshop in inflammatory bowel diseases according to psychosocial profiles. Clinical trial

Abstract Background The main objective in the management of chronic diseases is to maintain and improve the quality of life. In this sense, the involvement of the patient in their self-care should be a priority for nursing, but we know that the results are not always the desired ones. Self-care education and training should focus on social and emotional aspects, identified as predictors of the deterioration of the quality of life. Studies have identified psychosocial profiles (Controlled, Reinforced, Weak, Fragile) of patients with inflammatory bowel diseases (IBD) based on their level of social support and emotional coping. These profiles could predict the effectiveness of these educational workshops. This study aims to compare the effectiveness of a self-management workshop in different patient profiles to identify what type of patient might benefit and which don’t. Methods Non-randomised clinical trial. 61 outpatients were included. Inclusion criteria: Have IBD, be over 18 years old and sign the informed consent. They were included in a self-management training programme to learn about the disease and coping. There were 4 sessions in a month. They completed a questionnaire before the workshop, at the end of the workshop, at 3 months and at 6 months. The variables were sociodemographic, clinical, quality of life, coping, perceived stress, social support and anxiety-depression. Results The characteristics of the sample are shown in Table 1. The four psychosocial profiles described in the literature were identified and the effectiveness of the workshop in each one was analysed. The intrasubject linear analysis showed a linear type increase in the quality of life of patients with Reinforced and Weakening profile, between baseline and third month (−3.81, p = 0.036, CI: (− 7.45; −0.17) and − 6.21, p = 0.004, CI: (− 11.08; −1.35) respectively). The observed power was 91.5% and 93.8% for each case. However, no significant differences were found in patients with Controlled profile and Fragiles. The results found were not associated with other variables of the study. Conclusion Identifying psychosocial profiles allows us to succeed with the type of education we offer to patients. We must customise the information and resources. In the case of patients with a great lack of family support, one would first have to intervene with the family and then offer emotional education and not vice versa.

Effects of a Proactive Interdisciplinary Self-Management Program on Patient Self-Efficacy and Participation During Practice Nurse Consultations: A Randomized Controlled Trial in Type 2 Diabetes.

BackgroundNowadays, patients with chronic conditions such as type 2 diabetes mellitus (T2DM) need and want to be more active participants in their health care. This study aimed to investigate the effects of the Proactive Interdisciplinary Self-Management (PRISMA) training program on participation during consultations with practice nurses and self-efficacy of patients with T2DM in general practice.MethodsWithin a randomized controlled trial, patients were followed for 6 months. They received either PRISMA in addition to usual care or usual care only. Self-efficacy was assessed using the 5-item Perceived Efficacy in Patient-Physician Interactions (PEPPI-5) scale. Consultations were video-recorded and analyzed using the Roter interaction analysis system. Multilevel analysis was carried out.ResultsNo differences in the PEPPI-5 were found between the intervention (n = 101) and control groups (n = 102) (U = 1,737.5, z = -0.2, P = 0.8). In addition, the groups did not differ in patient participation. However, patients who attended the PRISMA program expressed more counselling utterances (B = 0.22; standard error (SE) = 0.09).ConclusionsPRISMA did not result in higher self-efficacy or patient participation during the consultation with practice nurses at 6 months. Possibly, two training sessions are insufficient and a more powerful intervention might be needed. However, the study showed indications that patients counselled themselves more frequently during the consultation. Practice nurses could stimulate patients who are already engaged in self-counselling by further specifying their goals of behavior change.

Стратегія самоменеджменту у навчальних програмах для пацієнтів із хронічним обструктивним захворюванням легень

Kateryna Tymruk-Skoropad, Iuliia Pavlova & Nadiya Sydoryk The aim of modern therapy for chronic obstructive pulmonary disease (COPD) is to reduce the severity of symptoms and prevent the development of relapse exacerbations, maintain pulmonary function at an optimal level and improve the quality of life of patients. The solution to these problems is pulmonary rehabilitation. Search for effective ways of providing an educational component, assessing the impact of various training programs and implementing a self-management strategy continues. Purpose: to analyze modern approaches, advantages and disadvantages of educational programs on self-management of people with COPD and establish the role of a physical therapy specialist in providing them. Material & Methods: the search was conducted on the resource of the US National Center for Biotechnological Information PubMed and in the database of scientific evidence on physical therapy PEDro. According to the results of the search in the databases, 329 links were obtained, of which, after excluding those that did NOT meet the necessary criteria, 14 publications were selected for subsequent analysis. Results: 29 educational topics related to self-management education were identified, which in different combinations are recommended for study in educational programs for patients with COPD. Training topics were grouped into four training modules that took into account the goals and objectives of the self-management strategy and ensure their solution. The most often competent in implementing educational programs for patients with COPD are a pulmonologist, physical therapist, nurse, pharmacist, occupational therapist, and social worker. The content, results, advantages and limitations of various self-management training programs are analyzed. Conclusions: today there are not enough practical recommendations and clear criteria that training programs on self-management for patients with COPD should meet. The analysis of modern clinical studies on the introduction of self-management training is the basis for the development of Ukrainian-language training programs.

National survey of diabetes self-management program coordinators views about pharmacists’ roles in diabetes education

ObjectivesTo examine the viewpoints of diabetes self-management training (DSMT) program coordinators about the roles and engagement of pharmacists who participate in DSMT programs, and the engagement between community pharmacies and DSMT programs by developing and administering a nationwide survey. DesignA mixed-methods exploratory sequential design; initial qualitative phase followed by a quantitative phase. Six in-depth interviews of DSMT program coordinators and intensive literature review informed the development of a 20-item survey instrument. Survey responses were descriptively analyzed, and themes were generated from context analysis of open-ended questions to generate the overall findings. Setting and participantsThe survey was distributed in 2017 to 742 active American Association of Diabetes Educators DSMT program coordinators in the United States. Outcome measuresProportion of DSMT programs engaging pharmacists and description of pharmacist’s roles. Content areas pharmacists teach in DSMT programs. Challenges faced by pharmacists in completing 1000 direct patient hours as a prerequisite for attaining Certified Diabetes Educator certification and strategies used to overcome them. Perceived benefits of pharmacist involvement by coordinators and patients. ResultsOne-third of DSMT programs have pharmacists involved with most using pharmacists as educators. Coordinators believe that pharmacist care is highly beneficial to patients and recognize that community pharmacist’s care is an added benefit to patients. However, collaborative practices are not well established between community pharmacists and DSMT programs. Program coordinators identified challenges they face when trying to involve community pharmacists in program delivery. ConclusionCoordinators of DSMT programs and their patients see pharmacists’ care as highly beneficial within DSMT programs. Increasing participation and scope of community pharmacists’ involvement is desired by both DSMT coordinators and the patients they serve. There is substantial growth potential for both greater involvement of pharmacists in DSMT programs and enhancing links to community pharmacists’ care.

Effects of the Proactive interdisciplinary self-management (PRISMA) program on self-reported and clinical outcomes in type 2 diabetes: a pragmatic randomized controlled trial

BackgroundDiabetes self-management education can be helpful for patients with type 2 diabetes in managing their condition. We aimed to study the effects of the group-based PRoactive Interdisciplinary Self-MAnagement (PRISMA) training program on self-reported and clinical outcomes in patients with type 2 diabetes treated in general practice.MethodsPersons aged 18 years or older diagnosed with type 2 diabetes and treated in primary care were included. In a randomized controlled trial design (1:1), patients were followed for 6 months with an extension phase of 6 months. Block randomization was used. The patients with type 2 diabetes received either PRISMA in addition to usual care or usual care only. All patients completed a range of validated questionnaires (including knowledge, skills, and confidence for self-management [PAM], diabetes self-care behavior [SDSCA], health-related quality of life [EQ-5D], and emotional well-being [WHO-5]). In addition, clinical outcomes (HbA1c, body mass index, systolic blood pressure, and cholesterol levels) were collected during the routine diabetes checkups.ResultsOf the total sample (n = 193), 60.1% were men. The mean age was 69.9 years (SD = 9.1). No significant differences were found on self-reported outcomes between the groups at 0, 6, and 12 months. The clinical outcomes were not reported due to a large number of missing values.ConclusionPRISMA did not improve self-reported outcomes in patients with type 2 diabetes treated in primary care. It was not possible to make a statement about the clinical effects.Trial registrationdate: 16/07/2014, number: NL4550 (https://www.trialregister.nl/trial/4550).