The Impact of Patient-Centered versus Didactic Education Programs in Chronic Patients by Severity- The Case of Type 2 Diabetes Mellitus

Jun 1, 2016, 00:00
10.1016/j.jval.2016.01.014
https://www.valueinhealthjournal.com/article/S1098-3015(16)00020-6/fulltext
Title : The Impact of Patient-Centered versus Didactic Education Programs in Chronic Patients by Severity- The Case of Type 2 Diabetes Mellitus
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(16)00020-6&doi=10.1016/j.jval.2016.01.014
First page : 353
Section Title : Comparative Effectiveness Research/HTA
Open access? : No
Section Order : 7

Background

Education leads to better health-related decisions and protective behaviors, being especially important for patients with chronic conditions. Self-management education programs have been shown to be beneficial for patients with different chronic conditions and to have a higher impact on health outcomes than does didactic education.

Objective

To investigate improvements in glycemic control (measured by glycated hemoglobin A1c) in patients with type 2 diabetes mellitus.

Methods

Our comparative trial involved one group of patients receiving patient-centered education and another receiving didactic education. We dealt with selection bias issues, estimated the different impact of both programs, and validated our analysis using quantile regression techniques.

Results

We found evidence of better mean glycemic control in patients receiving the patient-centered program, which engaged better patients. Nevertheless, that differential impact is nonmonotonic. Patients initially at the healthy range at the patient-centered program maintained their condition better. Patients close to, but not within, the healthy range benefited equally from attending either program. Patients with very high glycemic level benefited significantly more from attending the patient-centered program. Finally, patients with the worst initial glycemic control (far from the healthy range) improved equally their diabetic condition, regardless of which program they attended.

Conclusions

Different patients are sensitive to different categories of education programs. The optimal, cost-effective design of preventative programs for patients with chronic conditions needs to account for the different impact in different “patient categories.” This implies stratifying patients and providing the appropriate preventative education program, or looking for alternative policy implementations for unresponsive patients who have the most severe condition and are the most costly.

Categories :
  • Clinical Outcomes
  • Comparative Effectiveness or Efficacy
  • Diabetes/Endocrine/Metabolic Disorders
  • Specific Diseases & Conditions
Tags :
  • chronic disease self-management
  • patient-centered education
  • quantile regression
Regions :
  • Africa
  • Eastern and Central Europe
  • Middle East
  • Western Europe
ViH Article Tags :