Article Text

other Versions

PDF
General practice and social service partnership for better clinical outcomes, patient self efficacy and lifestyle behaviours of diabetic care: randomised control trial of a chronic care model
  1. Albert Lee1,
  2. Choi-Fong Siu2,
  3. Kam-Tao Leung2,
  4. Louisa C H Lau1,
  5. Cathy C M Chan2,
  6. Kwok-Keung Wong3
  1. 1School of Public Health and Primary Care, The Chinese University of Hong Kong, Lek Yuen Health Centre, Shatin, NT, Hong Kong
  2. 2Community Rehabilitation Network, Hong Kong Society of Rehabilitation, Pokfulam, Hong Kong
  3. 3Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, Lek Yuen Health Centre, Shatin, NT, Hong Kong
  1. Correspondence to Albert Lee, School of Public Health and Primary Care, The Chinese University of Hong Kong, 4th Floor, Lek Yuen Health Centre, Shatin, NT, Hong Kong; alee{at}cuhk.edu.hk

Abstract

Background The International Diabetes Attitudes, Wishes, and Needs (DAWN) programmes have shown the existence of a critical gap in self management support and access to the support system. This study aims to evaluate the effectiveness of the diabetes mellitus (DM) self management programme, with partnership between general practice and social work, on clinical outcomes, patient self efficacy and lifestyle behaviours.

Methods In this is single blind randomised controlled trial, subjects were recruited from patients attending general outpatient clinics in the Hospital Authority New Territory East Cluster of Hong Kong. 157 subjects meeting the inclusion criteria completed the study and were randomly assigned to the experimental or control group. The experimental group underwent the six sessions of weekly DM self management course with emphasis on self efficacy and participatory approach. The outcome measurements included HbA1c concentration, DM self efficacy scale, dietary behaviours, body mass index (BMI), and waist: hip ratio.

Results Baseline assessment observed no significant differences between experimental and control groups for the variables related to outcomes. For the experimental group, the proportion of subjects with normal HbA1c increased from 4.5% (3/66) at baseline to 28.6% (19/66) at week 28 (p<0.001), but there was insignificant improvement in the control group (3.9% to 11.8%, p=0.13). Repeated measure of analysis of variance showed pronounced improvement in DM self efficacy scale and BMI among the experimental group with significant interaction. Dietary behaviours also improved significantly in the experimental group.

Conclusion The DM care model with partnership between general practice and social work demonstrated better diabetic control with improvement of self efficacy and minimisation of risk behaviours.

Trial registration Current Controlled Trials ISRCTN78882965.

  • Diabetes mellitus
  • self efficacy
  • general practice and social work partnership
  • chronic care model
  • general diabetes
  • organisation of health services
  • medical education & training
  • primary care

Statistics from Altmetric.com

Footnotes

  • Funding Other funders: self funded.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The study was approved by The Chinese University of Hong Kong and Hospital Authority NT East Cluster Clinical Research Ethics Committee. CRE-2007, 136-T.

  • Provenance and peer review Not Commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.