Effect of a participant‐driven health education programme in primary care for people with hyperglycaemia detected by screening: 3‐year results from the Ready to Act randomized controlled trial (nested within the ADDITION‐Denmark study). Issue 8 (15th April 2014)

• Record Type: Journal Article
• Authors: Maindal, H. T.; Carlsen, A. H.; Lauritzen, T.; Sandbaek, A.; Simmons, R. K.
• Is Part Of: Diabetic medicine. Volume 31:Issue 8(2014:Aug.)
• Page Start: 976
• Page End: 986
• Publication Date: 2014-04-15
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12440
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" id="dme12440-abs-0001"> <title>Abstract</title> <sec id="dme12440-sec-0001" sec-type="section"> <title>Aim</title> <p>To assess whether a 12‐week participant‐driven health education programme offered to individuals with screening‐detected hyperglycaemia in Danish primary care would lead to improvements in cardiovascular risk factors, health behaviour and patient‐reported outcomes after 3 years.</p> </sec> <sec id="dme12440-sec-0002" sec-type="section"> <title>Methods</title> <p>We conducted a randomized controlled trial in 509 patients with screening‐detected hyperglycaemia (impaired fasting glucose, impaired glucose tolerance or Type 2 diabetes) from 33 general practices in Denmark. Individuals were pre‐randomized to receive (i) routine care (<italic>n</italic> = 187), or (ii) an invitation to participate in the Ready to Act health education programme (<italic>n</italic> = 322). The programme was delivered over 12 weeks in primary care and focused on motivation, action experience, informed decision‐making and social involvement to promote health behaviour change. The primary outcome was 10‐year modelled cardiovascular risk.</p> </sec> <sec id="dme12440-sec-0003" sec-type="section"> <title>Results</title> <p>Of 322 individuals, 123 (38%) received the intervention and 436/509 individuals (86%) returned for follow‐up assessment. There was no difference between the trial groups in modelled cardiovascular risk at 3 years (relative difference: 1.01; 95% CI: 0.84 to 1.23). Total cholesterol was lower (−0.24mmol/l, 95% CI: −0.45 to −0.03, <italic>P</italic> = 0.027), and patient activation was higher in the intervention than in the control group (5.3, 95% CI: 0.97 to 9.7). No other between‐group differences were observed for any cardiovascular risk factor, health behaviour or patient‐reported outcome variables. Subgroup analyses suggested that the intervention was more beneficial in those with impaired fasting glucose/impaired glucose tolerance than in those with Type 2 diabetes.</p> </sec> <sec id="dme12440-sec-0004" sec-type="section"> <title>Conclusion</title> <p>For patients with screening‐detected hyperglycaemia, a participant‐driven health education programme was not associated with improvements in most clinical, behavioural and patient‐reported outcomes after 3 years of follow‐up.</p> </sec> </abstract>