Effects of diabetes self-management programs on time-to-hospitalization among patients with type 2 diabetes: A survival analysis model

Abstract

Objective This study compared time-to-hospitalization among subjects enrolled in different diabetes self-management programs (DSMP). We sought to determine whether the interventions delayed the occurrence of any acute event necessitating hospitalization. Methods Electronic medical records (EMR) were obtained for 376 adults enrolled in a randomized controlled trial (RCT) of Type 2 diabetes (T2DM) self-management programs. All study participants had uncontrolled diabetes and were randomized into either: personal digital assistant (PDA), Chronic Disease Self-Management Program (CDSMP), combined PDA and CDSMP (COM), or usual care (UC) groups. Subjects were followed for a maximum of two years. Time-to-hospitalization was measured as the interval between study enrollment and the occurrence of a diabetes-related hospitalization. Results Subjects enrolled in the CDSMP-only arm had significantly prolonged time-to-hospitalization (Hazard ratio: 0.10; p = 0.002) when compared to subjects in the control arm. Subjects in the PDA-only and combined PDA and CDSMP arms showed no improvements in comparison to the control arm. Conclusion CDSMP can be effective in delaying time-to-hospitalization among patients with T2DM. Practice implications Reducing unnecessary healthcare utilization, particularly inpatient hospitalization is a key strategy to improving the quality of health care and lowering associated health care costs. The CDSMP offers the potential to reduce time-to-hospitalization among T2DM patients.

Effect of a structured diabetes education programme in primary care on hospitalizations and emergency department visits among people with Type 2 diabetes mellitus: results from the Patient Empowerment Programme

“…The results of the present study are consistent with three previous studies [14][15][16] which examined the effects of a diabetes education programme on hospital service utilization over a prolonged follow-up period. A structured diabetes education group in a Korean study had a significantly lower frequency of diabetes-related hospitalizations than a control group after a median follow-up of 4 years, and results from a retrospective cohort study showed that an education programme was significantly associated with delaying first hospitalization events.…”

Patient Empowerment Programme in primary care reduced all‐cause mortality and cardiovascular diseases in patients with type 2 diabetes mellitus: a population‐based propensity‐matched cohort study

“…The impact of PEP on CVD benefit might be attributable to improvement in intermediate outcomes such as metabolic control through empowerment of self-care and the enhancement of quality of diabetes care in primary care. Nonetheless, given the paucity of longitudinal data on observed events among subjects who do or do not take part in diabetes education programmes, only the association of a diabetes education programme with occurrence of diabetes-related hospitalization has been investigated to date [22]. A recent study showed that subjects enrolling in an education programme generally had a significant HR of 0.10 (95% CI 0.023-0.438; p = 0.002) of being hospitalized because of diabetes-related acute events when compared with subjects in a control group.…”

Clinical and socio-demographic determinants of self-care behaviours in patients with heart failure and diabetes mellitus: A multicentre cross-sectional study

“…In heart failure, self-care reduces hospitalization rates , health-care costs (Hamar et al, 2015) and mortality (Smith et al, 2014), and improves quality of life (Clark et al, 2015). In diabetes mellitus, self-care improves metabolic control , Yuan et al, 2014 and quality of life (Chao et al, 2015, Kargar Jahromi et al, 2015 and reduces cardiovascular risk (Powers et al, 2015, Sicuro et al, 2014, hospitalizations (Adepoju et al, 2014) and disease-related complications (Kargar Jahromi et al, 2015, Shreck et al, 2014, Williams et al, 2014. Unfortunately, self-care is suboptimal in both heart failure and diabetes mellitus patients , Dunbar et al, 2014, Dungan et al, 2013, Jaarsma et al, 2013, Kerr et al, 2007, Saleh et al, 2014, Ware et al, 2006, and when more than one illness is active, self-care becomes particularly challenging (Gallacher et al, 2011, Schmitt et al, 2014.…”