IAPT and Long Term Medical Conditions: What Can We Offer?

2014 ◽  
Vol 43 (4) ◽  
pp. 412-425 ◽  
Author(s):  
Abigail L. Wroe ◽  
Edward W. Rennie ◽  
Sarah Gibbons ◽  
Arek Hassy ◽  
Judith E. Chapman
Keyword(s):  
Psychological Wellbeing ◽  
Self Management ◽  
Service Development ◽  
Medical Conditions ◽  
Client Group ◽  
Department Of Health ◽  
Outcomes Measures ◽  
Pilot Work

Background: The proposal of a 4-year plan to integrate treatment of people with long term medical conditions (LTCs) into the IAPT service (Department of Health, 2011) seeks for research to understand the effectiveness of IAPT interventions for this patient group. Aim: The aim of this service development pilot work was to develop an intervention that is effective for people with Type 2 Diabetes Mellitus (T2DM). It was hypothesized that the standard IAPT intervention would not be effective, but that it can be adapted so that it is effective both in terms of mood and self-management of T2DM. Method: Clients (n = 95) who experienced mild to moderate depression and/or anxiety and had a diagnosis of T2DM opted to attend. The intervention was adapted over a series of cohorts from a standard Step 2 intervention. A team of Psychological Wellbeing Practitioners (PWPs), a Clinical Health Psychologist and a General Practitioner worked in collaboration, using outcomes measures and feedback from service users and facilitators. Results: The standard IAPT Step 2 intervention met with challenges when specifically targeting this client group. Using paired t-tests, the modified Step 2 intervention demonstrated significant improvements from pre- to postintervention measures both in terms of psychological (n = 17) and physical (n = 9) outcomes. Conclusion: It is concluded that it may be possible to modify a generic Step 2 IAPT intervention to demonstrate improvements both in terms of psychological wellbeing and self-management of T2DM. The main adaptations were related to more targeted recruitment and linking of diabetes specifically into the CBT model.

scholarly journals Long-Term Engagement With a Mobile Self-Management System for People With Type 2 Diabetes

2013 ◽  
Vol 1 (1) ◽  
pp. e1 ◽  
Author(s):  
Naoe Tatara ◽  
Eirik Årsand ◽  
Stein Olav Skrøvseth ◽  
Gunnar Hartvigsen
Keyword(s):  
Type 2 Diabetes ◽  
Management System ◽  
Self Management

Implementation of a Self-management Programme for People with Long-Term Medical Conditions in a Workplace Setting

2007 ◽  
Vol 38 (2) ◽  
pp. 24-34 ◽  
Author(s):  
Julie H. Barlow ◽  
David R. Ellard
Keyword(s):  
Working Life ◽  
Support Staff ◽  
Self Management ◽  
Medical Conditions ◽  
Management Intervention ◽  
Organisational Support ◽  
Before And After ◽  
The Uk ◽  
Workplace Setting

The Expert Patient Programme (EPP) is a lay-led self management intervention, delivered in the community and is designed for people with long-term medical conditions (LTMCs). It is now widely used and accepted in the UK. The aims of this qualitative study were to examine whether implementation of the lay-led EPP in a workplace setting is perceived to benefit employees with LTMCs and to examine their existing organisational support. This article presents the results of interviews with employees before and after they attended the work-based EPP and also the views of managers that have to support staff that work with LTMCs. The results suggest that having LTMCs interferes with working life and that managers perceive that they do not have enough support to help people with LTMCs. The EPP proved to be of assistance to participants and could, with minor adaptations, be used effectively in a workplace setting.

scholarly journals Experiences of using a digital type 2 diabetes prevention application designed to support women with previous gestational diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Winifred Ekezie ◽  
Helen Dallosso ◽  
Ponnusamy Saravanan ◽  
Kamlesh Khunti ◽  
Michelle Hadjiconstantinou
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Focus Group ◽  
Gestational Diabetes ◽  
Technical Skills ◽  
Self Management ◽  
Focus Group Discussions ◽  
Group Discussions

Abstract Background Gestational diabetes mellitus (GDM) is diagnosed during pregnancy, and women with a history of GDM are at a higher risk of developing type 2 diabetes mellitus (T2DM). Prevention strategies focused on lifestyle modification help to reduce long-term complications. Self-management technology-based interventions can support behaviour change and diabetes control. The Baby Steps programme, a randomised controlled trial intervention offering group education and access to a mobile web application, was evaluated to explore user experience of the app and barriers and facilitators to app usability. Methods Ten semi-structured interviews and four focus group discussions were conducted with 23 trial participants between 2018 and 2019. Interviews and focus group discussions were audiotaped, transcribed and independently analysed. The analysis was informed by thematic analysis, with the use of the Nvivo 12 software. Results Themes identified were: (1) GDM and post-pregnancy support from healthcare services; (2) Impact of Baby Steps app on lifestyle changes; (3) Facilitators and barriers to the usability of the Baby Steps app. The Baby Steps app served as a motivator for increasing self-management activities and a tool for monitoring progress. Peer support and increased awareness of GDM and T2DM enhanced engagement with the app, while poor awareness of all the components of the app and low technical skills contributed to low usability. Conclusions This study documents experiences from existing GDM support, user experiences from using the Baby Steps app, and the barriers and facilitators to app usability. The app was both a motivational and a monitoring tool for GDM self-management and T2DM prevention. Peer support was a key trait for enhanced engagement, while barriers were low technical skills and poor awareness of the app components. A digital app, such as the Baby Steps app, could strengthen existing face-to-face support for the prevention of T2DM. The results also have wider implications for digital support technologies for all self-management interventions. Further research on the effect of specific components of apps will be required to better understand the long term impact of apps and digital interventions on self-management behaviours and outcomes. Trial registration ISRCTN, ISRCTN17299860. Registered on 5 April 2017.

scholarly journals Long-term effectiveness of group-based diabetes self-management on glycosylated haemoglobin for people with type 2 diabetes in community: a protocol of systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046692
Author(s):  
Zhang Xia ◽  
Ying-ying Jiang ◽  
Wei-jing Shang ◽  
Hai-jun Guo ◽  
Fan Mao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Self Management ◽  
Controlled Trials ◽  
Long Term Effects ◽  
Group Education ◽  
Management Group

IntroductionThe rapid rise in the prevalence of diabetes has a negative impact on patients’ quality of life. Diabetes self-management group education is cost-effective and efficient for patients to control blood glucose. However, there are no consistent standards for self-management group education, and its long-term effects (≥12 months) are unclear. Although a few systematic reviews evaluated the long-term effects, they did not make clear provisions on the content of self-management, and the number and sample size of included studies were small, which may lead to misclassification bias and reporting bias. Therefore, we plan to conduct this systematic review to evaluate the long-term effects of self-management group education and determine the effects of different self-management characteristics on glycosylated haemoglobin (HbA1c).Methods and analysisWe will retrieve Chinese databases (Wanfang, Chinese Hospital Knowledge Warehouse) and English databases (PubMed, ScienceDirect, EMBASE, Web of Science, Bailian Platform, Cochrane Central Register of Controlled Trials, Google Scholar) for randomly controlled trials and cluster randomly controlled trials of which participants are adults with type 2 diabetes mellitus. We will manually search citation lists and trial registries, and consult authors to obtain relevant articles. The retrieval time range will be from the establishment of the database to July 2020 to avoid omitting relevant studies. The primary outcome will be HbA1c. The secondary outcomes will be fasting plasma glucose, postprandial blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference and death event. Two reviewers will independently conduct article screening and assessment of risk of bias, with a third reviewer arbitrating if necessary. We will give priority to the use of meta-analysis to evaluate the pooled effects of all outcomes. For the outcomes of unrecognised sources of heterogeneity, missing data and less than three related studies, narrative synthesis approach will be used.Ethics and disseminationEthical approval is not required for this systematic review. We plan to present the findings in a peer-reviewed scientific journal, relevant and responsible organisations, and training meetings.PROSPERO registration numberCRD42020209011.

scholarly journals The Long-Term Effects of Self-Management Education for Patients With Type 2 Diabetes on Glycemic Control: Response to Norris et al.

Diabetes Care ◽  
2002 ◽  
Vol 25 (11) ◽  
pp. 2115-2116 ◽  
Author(s):  
H. Sone ◽  
H. Ito ◽  
Y. Saito ◽  
H. Yamashita ◽  
S. Ishibashi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Management Education ◽  
Self Management ◽  
Long Term Effects ◽  
Control Response

Structured education for people with type 2 diabetes mellitus

2011 ◽  
pp. 1811-1818
Author(s):  
Simon R. Heller ◽  
Marian E. Carey
Keyword(s):  
Type 2 Diabetes ◽  
Long Term Care ◽  
Management Education ◽  
Evidence Base ◽  
Self Management ◽  
Term Care ◽  
Structured Education ◽  
The Uk

This chapter discusses how structured self-management education has become an integral component of the long-term care of type 2 diabetes in supporting individuals to initiate and sustain effective self-management. We will briefly explore the background and context for structured education, identify and discuss its defining characteristics, and briefly comment on the evidence base as reported in the last 10 years. Finally, drawing on currently active structured self-management programmes in the UK and Europe as exemplars, we will examine the benefits of structured education in terms of the patient outcomes reported in some key research studies.

scholarly journals Self-management Education Program: The Case of Glycemic Control of Type 2 Diabetes

2021 ◽  
Vol 36 (1) ◽  
pp. e225-e225
Author(s):  
Emmanuel Kumah ◽  
Aaron Asibi Abuosi ◽  
Samuel Egyakwa Ankomah ◽  
Cynthia Anaba
Keyword(s):  
Type 2 Diabetes ◽  
Management Education ◽  
Educational Interventions ◽  
Self Management ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Management Interventions ◽  
The Impact

Objectives: Self-management education (SME) is recognized globally as a tool that enables patients to achieve optimal glucose control. While factors influencing the effectiveness of self-management interventions have been studied extensively, the impact of program length on clinical endpoints of patients diagnosed with diabetes is underdeveloped. This paper synthesized information from the existing literature to understand the effect of program length on glycated hemoglobin (HbA1C) in adults with type 2 diabetes mellitus. Methods: We searched Web of Science, PubMed, Scopus, MEDLINE, EMBASE, PsychINFO, and the Cochrane Central Register of Controlled Trials to identify relevant English language publications on diabetes selfmanagement education published between January 2000 and April 2019. Results: The review included 25 randomized controlled trials, with 64.0% reporting significant changes in HbA1C. The studies classified as long-term (lasting one year and above) were associated with the greatest number of interventions achieving statistically significant (87.5% significant vs. 12.5% non-significant) differences in changes in HbA1C between the intervention and the control subjects, recording an overall between-group HbA1C mean difference of 0.6±0.3% (range = 0.2–1.2). Conclusions: Our findings suggest that program length may change the effectiveness of educational interventions. Achieving sustained improvements in patients’ HbA1C levels will require long-term, ongoing SME, and support.

scholarly journals Diabetes Self-Management Education: Miles to Go

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Helen Altman Klein ◽  
Sarah M. Jackson ◽  
Kenley Street ◽  
James C. Whitacre ◽  
Gary Klein
Keyword(s):  
Management Education ◽  
Meta Analysis ◽  
Self Management ◽  
Post Intervention ◽  
Self Monitoring ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Impact

This meta-analysis assessed how successfully Diabetes Self-Management Education (DSME) interventions help people with type 2 diabetes achieve and maintain healthy blood glucose levels. We included 52 DSME programs with 9,631 participants that reported post-intervention A1c levels in randomized controlled trials. The training conditions resulted in significant reductions in A1c levels compared to control conditions. However, the impact of intervention was modest shifting of only 7.23% more participants from diabetic to pre-diabetic or normal status, relative to the control condition. Most intervention participants did not achieve healthy A1c levels. Further, few DSME studies assessed long-term maintenance of A1c gains. Past trends suggest that gains are difficult to sustain over time. Our results suggested that interventions delivered by nurses were more successful than those delivered by non-nursing personnel. We suggest that DSME programs might do better by going beyond procedural interventions. Most DSME programs relied heavily on rules and procedures to guide decisions about diet, exercise, and weight loss. Future DSME may need to include cognitive self-monitoring, diagnosis, and planning skills to help patients detect anomalies, identify possible causes, generate corrective action, and avoid future barriers to maintaining healthy A1c levels. Finally, comprehensive descriptions of DSME programs would advance future efforts.

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