Group follow-up compared to individual clinic visits after structured education for type 1 diabetes: A cluster randomised controlled trial

Dinneen, Séan F.; O’Hara, Mary Clare; Byrne, Molly; Smith, Diarmuid; Courtney, Christopher H.; McGurk, C.; Heller, Simon; Newell, John; Coffey, Norma; Breen, Cathy; O'Scannail, M; O’Shea, Donal

doi:10.1016/j.diabres.2013.01.017

Cited by 34 publications

(47 citation statements)

References 26 publications

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“…It is noteworthy that another recent trial of the DAFNE intervention has also failed to show much improvement in HbA 1c levels. 85 We also assessed psychosocial outcomes, which reinforce the findings of other DAFNE studies 12,14,74,85 in demonstrating marked improvements across a range of measures at 6 months and maintenance at 12 months, with no differences between participants in the two different arms.…”

Section: Discussionsupporting

confidence: 51%

“…Our findings also offer insights into what this continuing support should comprise. Despite growing interest in the use of group-based follow-up support to promote self-management of diabetes and other chronic conditions, our results, alongside those of others, 85,86 raise questions and concerns about promoting group-based support in routine clinical practice, particularly if this type of support is offered in isolation from other inputs and interventions. This is because a group-based approach may be incompatible with type 1 diabetes patients' need for individualised input from health professionals post course.…”

Section: Resultsmentioning

confidence: 64%

See 1 more Smart Citation

Improving management of type 1 diabetes in the UK: the Dose Adjustment For Normal Eating (DAFNE) programme as a research test-bed. A mixed-method analysis of the barriers to and facilitators of successful diabetes self-management, a health economic analysis, a cluster randomised controlled trial of different models of delivery of an educational intervention and the potential of insulin pumps and additional educator input to improve outcomes

Heller

Lawton

Amiel

et al. 2014

Programme Grants for Applied Research

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Improving management of type 1 diabetes in the UK: the Dose Adjustment For Normal Eating (DAFNE) programme as a research test-bed. A mixed-method analysis of the barriers to and facilitators of successful diabetes self-management, a health economic analysis, a cluster randomised controlled trial of different models of delivery of an educational intervention and the potential of insulin pumps and additional educator input to improve outcomes

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Section: Discussionsupporting

confidence: 51%

Section: Resultsmentioning

confidence: 64%

Improving management of type 1 diabetes in the UK: the Dose Adjustment For Normal Eating (DAFNE) programme as a research test-bed. A mixed-method analysis of the barriers to and facilitators of successful diabetes self-management, a health economic analysis, a cluster randomised controlled trial of different models of delivery of an educational intervention and the potential of insulin pumps and additional educator input to improve outcomes

Heller

Lawton

Amiel

et al. 2014

Programme Grants for Applied Research

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“…In the Irish DAFNE Study 10 , we showed improvements in (1) perceived burden of diabetes (measured by PAID) and (2) both the total quality of life and treatment satisfaction scores on the DSQOLS among a cohort of 437 DAFNE graduates, at 18 month follow up post participation in the DAFNE intervention. From baseline to 18 month follow up, PAID scores decreased on average by 9.13 percentage points, where lower scores indicated lower levels of distress (95% CI -10.63 to -7.64, p<0.001).…”

Section: Introductionmentioning

confidence: 90%

Predictors of quality of life gains among people with type 1 diabetes participating in the Dose Adjustment for Normal Eating (DAFNE) structured education programme

Byrne

Coffey

Hara

et al. 2012

Diabetes Research and Clinical Practice

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Aims: To examine predictors of quality of life gains among people with type 1 diabetes following DAFNE (Dose Adjustment for Normal Eating) self-management training programme.Methods: Clinical and questionnaire data were collected from 437 patients from 6 hospital centres before, and at 18 month post, DAFNE intervention. Glycated haemoglobin (HbA 1c ), weight and height, and blood pressure levels were recorded by clinicians during clinic appointments. Questionnaires included the Diabetes-Specific Quality of Life Scale (DSQOLS), the Problem Areas in Diabetes Scale (PAID) and the Hospital Anxiety and Depression Scale (HADS). Basic demographics were recorded at baseline. Linear mixed models were fitted to identify predictors of change in quality of life at 18 month follow up.Results: Those with high levels of diabetes-related distress experienced greatest improvement in DSQOLS quality of life scores (p=0.001). Those with poor glycaemic control (higher levels of HbA 1c ; p=0.03) and those with high levels of anxiety (p=0.001) experienced greatest reductions in diabetes-related distress.Conclusions: Those with higher baseline levels of anxiety, higher levels of diabetes-related distress and higher baseline levels of HbA 1c are most likely to experience quality of life gain from participation in self-management programmes like DAFNE.

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“…81 They carried out a large randomised trial of group follow-up compared with individual clinic visits for patients who had understands how to use it and is physically able to use the system and l agrees to use the system while having a structured education programme on diet and lifestyle, and counselling.…”

Section: Overview Of Evidence Base For Pump Therapymentioning

confidence: 99%

A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial

Heller

White

Lee

et al. 2017

Health Technol Assess

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This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 08/107/01. The contractual start date was in June 2011. The draft report began editorial review in March 2016 and was accepted for publication in July 2016. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Published by the NIH...

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Group follow-up compared to individual clinic visits after structured education for type 1 diabetes: A cluster randomised controlled trial

Abstract: Our data suggest that group follow-up as the sole means of follow-up after structured education for individuals with type 1 diabetes is as effective as a return to one-to-one clinic visits.

Cited by 34 publications

References 26 publications

Predictors of quality of life gains among people with type 1 diabetes participating in the Dose Adjustment for Normal Eating (DAFNE) structured education programme

A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial

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