Changing Behavior: Practical lessons from the Diabetes Control and Complications Trial

Lorenz, Rodney A.; Bubb, Jeanne; Davis, Dianne; Jacobson, Alan F.; Jannasch, Karl; Kramer, John; Lipps, Janie; Schlundt, David G.

doi:10.2337/diacare.19.6.648

Cited by 77 publications

(38 citation statements)

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“…When asked what they liked best about the group visit experience, many participants noted the ability to freely ask questions and feel that they were listened to, which also corresponds with the longer time period and open format afforded by group visits. that most patients are able to maintain behavior changes and improve diabetes control when given appropriate support and educational opportunities [17]. Ninety-two percent of participants stated that their group visit experience had a positive impact on diabetes selfmanagement.…”

Section: Discussionmentioning

confidence: 99%

Patient Perceptions of a Diabetes Group Visit Experience

Careyva¹

2012

J Community Med Health Edu

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Context: This study assesses patient experiences with a diabetes group visit program in terms of satisfaction and impact on diabetes self-management. Preliminary data have demonstrated that group visits are a useful model to improve chronic disease management, particularly diabetes. To date, however, there is scarce data regarding patients' perceptions of these experiences.Objective: To determine patients' perceptions of their experiences with a diabetes group visit program as well as self-reported impact on diabetes management. Methods:The study involves a semi-structured interview administered over the phone to group visit attendants. Participation in the survey was voluntary, and the data was recorded without patient identifiers. Three experienced reviewers analyzed the results for emerging themes.Results: Twenty-five patients were interviewed. Eighty-four percent of patients reported attending the group visit because they were referred by their primary care physician. Most of the patients surveyed (88%) had completed at least three out of four sessions involved in the group visit program. Most patients (92%) reported that the group visit program influenced health behaviors related to diabetes including eating habits, blood glucose monitoring, taking medications, and exercise. Ninety-two percent of patients stated that they obtained more information about how to manage their diabetes during the group visit program than they had during traditional visits with their primary care provider. Conclusions:Group visits are an innovative and efficient tool for the dissemination of diabetes related selfmanagement education and support. Patients were most likely to attend if encouraged to do so by their primary care provider and most found that attending the class changed disease related behaviors.

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Section: Discussionmentioning

confidence: 99%

Patient Perceptions of a Diabetes Group Visit Experience

Careyva¹

2012

J Community Med Health Edu

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“…Multimodal adherence-enhancing strategies described elsewhere for diabetes and other conditions [14,15,25,26] were integrated as study procedures to promote adherence with the medication regimen and were implemented across centers. These included: periodic newsletters, social and informational events, quarterly clinic visits, personalized cards (e.g., celebrating birthday, life events, and study milestones), symbolic incentives (e.g., RASS T-shirt, coffee mug, sweatshirts of research sites’ universities), pill minders, and mid-visit telephone calls.…”

Section: Methodsmentioning

confidence: 99%

Adherence and renal biopsy feasibility in the Renin Angiotensin-System Study (RASS) primary prevention diabetes trial

Robiner

Strand

Mauer

2013

Diabetes Research and Clinical Practice

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Aims Enhancing adherence in research trials is fundamental to the proper testing of treatment hypotheses. Methods Regimen and follow-up adherence as well as factors associated with adherence in the Renin Angiotensin-System Study (RASS) diabetic nephropathy primary prevention trial were evaluated. Adherence to medication (i.e., pill count), follow-up visits, and follow-up renal biopsies was evaluated. Results 89.8% of subjects completed the second renal biopsy. 96% of follow-up visits were attended within prescribed time windows. Mean medication adherence was 85.6%. Subgroup analyses revealed greater declines in the least adherent participants over time. Factors associated with greater adherence levels included older age, type 1 diabetes (TIDM) duration, lower HbA1c and blood pressure, GFR, ethnicity, and participants’, principal investigators’ (PI), and trial coordinators’ (TC) baseline predictions of adherence. Conclusions T1DM patients without nephropathy were willing to take experimental medications and undergo repeat renal biopsies. Although overall adherence was excellent, patterns of adherence varied among participants, suggesting the need to better track adherence and to develop customized and targeted approaches for promoting adherence to clinical research regimens. Staff subjective predictions of adherence were imprecise, supporting need for further development of adherence predictors.

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“…O estudo The Diabetes Control and Complications Trial Research Group (2) mostrou que o tratamento intensivo do DM1 inquestionavelmente leva à redução das complicações microvasculares do diabetes, mas que esta intensificação do tratamento necessita efetivo automanejo, que requer processo educativo freqüente, com adequado suporte continuado (3)(4)(5). Embora algumas revisões demonstrem que intervenções educacionais tenham pequeno a médio efeito benéfico no controle glicêmico, elas parecem ter efeito maior nos desfechos psicológicos (6)(7)(8).…”

Section: Introductionunclassified

Organização de um serviço de assistência ao paciente com diabetes melito tipo 1

Tschiedel

Cé

Geremia

et al. 2008

Arq Bras Endocrinol Metab

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Neste artigo são apresentadas as bases para a organização de um serviço especializado em diabetes na infância e na adolescência. É mostrado o modo como foi implementado o Instituto da Criança com Diabetes do Rio Grande do Sul (ICD) e a esquematização de seu trabalho. Seus objetivos são: diminuir hospitalizações por situações agudas, diminuir a freqüência de complicações crônicas e capacitar recursos humanos. São atendidos, em regime ambulatorial e de hospital-dia, 1.315 pacientes, majoritariamente diabetes melito tipo 1, de maneira gratuita, pelo Sistema Único de Saúde (SUS), por meio de convênio com o Grupo Hospitalar Conceição, Ministério da Saúde. Um programa educativo diário é realizado, com aulas de 45 minutos de duração, que fazem parte da atenção ao paciente e à sua família. Mostra-se uma diminuição das internações hospitalares, de 2004 a 2007, de 7,5% para 2,7%. Também são apresentados os diversos esquemas terapêuticos seguidos pela equipe interdisciplinar do instituto no atendimento às diferentes faixas etárias.

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Changing Behavior: Practical lessons from the Diabetes Control and Complications Trial

Cited by 77 publications

References 0 publications

Patient Perceptions of a Diabetes Group Visit Experience

Patient Perceptions of a Diabetes Group Visit Experience

Adherence and renal biopsy feasibility in the Renin Angiotensin-System Study (RASS) primary prevention diabetes trial

Organização de um serviço de assistência ao paciente com diabetes melito tipo 1

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