EFFECTIVENESS OF A COMMUNITY-BASED TYPE 2 DIABETES SELF-MANAGEMENT EDUCATION PROGRAMME IN THE STATE OF PENANG, MALAYSIA
Author(s)
Wong YY1, Hassali MA1, Neoh CF2, Saleem F3, Kong DC4
1Universiti Sains Malaysia, Penang, Malaysia, 2Universiti Teknologi MARA, Puncak Alam, Malaysia, 3University of Baluchistan, Quetta, Pakistan, 4Monash University, Victoria, Australia
OBJECTIVES: To assess the effectiveness of a structured, group-based type 2 diabetes self-management education (T2DSME) programme on participant’s health outcomes. METHODS: A pre-post study design was employed. Adults diagnosed with Type 2 diabetes were invited to attend weekly, group-based self-management education offered in local community halls (average 2.5-hour per session for 6 consecutive weeks). The programme was developed by a multidisciplinary healthcare team (i.e. pharmacist, diabetic nurse educator, dietitian, physiotherapist and medical doctor). Empowerment philosophy and Bandura’s self-efficacy theory were applied. Participant’s clinical [HbA1c, fasting glucose, blood pressure, lipids, weight, body mass index (BMI) and waist circumference] and humanistic (knowledge related to diabetes management, self-care behaviours, self-efficacy and quality-of-life) outcomes were assessed at baseline, post 2-month and post 6-month of the programme. RESULTS: A total of 46 participants consented to the programme; 39 (84.8%) attended three or more sessions. After 2-month, participants demonstrated significant improvement in low-density lipoprotein cholesterol (p = 0.001), knowledge related to diabetes management (p = 0.025) and certain self-care behaviours including blood glucose monitoring (p < 0.001) and foot care (p = 0.024). The aforementioned outcomes were also maintained at 6-month. However, participants did not maintain the decreasing trend of HbA1c observed at 2-month with significant HbA1c increase reported at 6-month compared to 2-month (p < 0.001). At 6-month, other positive outcomes observed were improvement in high-density lipoprotein cholesterol (p = 0.029) and quality-of-life (p = 0.010). No significant differences were found in other outcomes (i.e. fasting glucose, blood pressure, triglycerides, weight, BMI, waist circumference, self-efficacy, diet, medication-taking and exercise components of self-care behaviour) between baseline, post-2 month and post-6 month of the programme. CONCLUSIONS: Findings suggest that short-term structured T2DSME may improve patient’s clinical and psychosocial outcomes. However, self-management education should be reinforced in a continuous manner to help patients in sustaining good glycaemic control.
Conference/Value in Health Info
2017-05, ISPOR 2017, Boston, MA, USA
Value in Health, Vol. 20, No. 5 (May 2017)
Code
PDB12
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Diabetes/Endocrine/Metabolic Disorders