scholarly journals Peer support program (P-SUP) to strengthen self-management in patients with chronic conditions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Giesen ◽  
H Könnecke ◽  
M Redaèlli ◽  
D Simic ◽  
M Heßbrügge ◽  
...  
Keyword(s):  
Peer Support ◽  
Support Groups ◽  
Chronic Conditions ◽  
Primary Outcome ◽  
Hospital Admissions ◽  
Self Management ◽  
Artery Disease ◽  
Telephone Coaching

Abstract Background Chronic care programmes (CCPs) ensure a standardised, evidence based and structured patient care. In Germany, CCPs are successful in improving quality of care and making care more patient-centred. Regarding self-management support, however, the programs only feature patient education and shared decisions on treatment goals. Peer support has proven to be a successful component in outpatient care to enhance self-management. The aim of this study is to support patients with type 2 diabetes and coronary artery disease in conducting successful self-management through a multimodal program. Methods This randomized controlled trial (RCT) is set up for 27 months and will include a study population of approximately 1800 patients, beginning in summer 2020. The primary outcome (PO) is the reduction of hospital admissions. In addition to the PO, secondary outcomes include motivational and knowledge-based aspects. Furthermore, health-competitive and health-economic data will be collected. The formative evaluation will review the processes for implementation. The central element of the intervention will be peer support groups, in which the group will participate in physical activities and educational lectures on nutrition, exercise or disease related knowledge. Additionally, a specially designed online platform, personalized feedback for patients on medical outcomes from their family doctors, and regular telephone coaching to increase intrinsic motivation and activation will be provided. Results In addition to the primary outcome (reduction of hospital admissions), increased motivation levels, improved quality of life and increased health literacy are expected. Conclusions This project, funded by the Federal Joint Committee (establishment of statutory health insurance funds and medical providers in Germany), can serve as a blueprint for future implementations of public health approaches and accessible care models for patients with chronic conditions. Key messages Peer support as a successful method to enhance self-management in patients with type 2 diabetes and coronary artery disease. A multimodal program, consisting of peer support groups, an online platform, personalized medical feedback and telephone coaching, aiming to improve quality of life in patients with chronic conditions.

Diabetes self-management: multiple technologies of self

2003 ◽  
Vol 9 (3) ◽  
pp. 61 ◽  
Author(s):  
Dorothy H Broom
Keyword(s):  
Chronic Conditions ◽  
Service Providers ◽  
Management Strategies ◽  
Diabetes Type 2 ◽  
Disease Status ◽  
Self Management ◽  
The Social ◽  
The Individual

Self-management is now positioned as essential to the optimal management of many chronic diseases. Health promoters and service providers often acknowledge that some forms of self-management are difficult and demanding, and that health education must be appropriately tailored in order to enhance ?compliance?. These discourses may recognise that part of a person?s response to diagnosis arises from the individual?s personality and their social circumstances. However, less attention is paid to the social and personal effects of the variety of strategies people deploy in order to manage an ongoing condition. Self-management affects more than symptoms or disease status; it also shapes the subjectivity of the person, so different management strategies may mould different selves. The self-management of diabetes entails numerous daily practices, and produces several distinct ways of constructing an embodied diabetic self. In this article, I describe how a sample of adults living with diabetes type 2 manage their diabetes from day to day, and how those activities both arise from, and contribute to, distinctive subject positions. Appreciating the daily and dynamic character of self-management may also help service providers to facilitate an improved quality of life for people with chronic conditions.

scholarly journals Effectiveness and cost-effectiveness of the Assessment of Burden of Chronic Conditions (ABCC) tool in patients with COPD, asthma, diabetes mellitus type 2 and heart failure: protocol for a pragmatic clustered quasi-experimental study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037693
Author(s):  
Esther A. Boudewijns ◽  
Danny Claessens ◽  
Manuela Joore ◽  
Lotte C.E.M. Keijsers ◽  
Onno C.P. van Schayck ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Experimental Study ◽  
Cost Effectiveness ◽  
Chronic Conditions ◽  
Self Management ◽  
Quasi Experimental ◽  
General Practices

IntroductionThe number of people that have one or multiple condition(s) with a chronic course is rising, which consequently challenges healthcare systems. Healthcare geared to long-term care should focus on patient-centredness, shared decision making and self-management. The Assessment of Burden of Chronic Conditions (ABCC) tool was developed to integrate these elements in daily healthcare practice. The ABCC tool assesses and visualises burden of disease(s), helps to make shared decisions and stimulates self-management. The present paper documents a protocol for a quasi-experimental study investigating the effectiveness and cost-effectiveness of the ABCC tool for people with chronic obstructive pulmonary disease, asthma, type 2 diabetes mellitus and/or heart failure.Methods and analysisThe study has a pragmatic clustered quasi-experimental design and will be conducted in the Netherlands. The intervention will be allocated at the level of general practice. The intervention group (18 general practices, 180 patients) will use the ABCC tool during regular consultations; the control group (18 general practices, 180 patients) will maintain usual care. Outcomes include change in quality of care (Patient Assessment of Chronic Illness Care), quality of life (EuroQol-5D-5L), capability well-being (ICEpop CAPability measure for Adults), patients’ activation (Patient Activation Measure) and costs. Follow-up time will be 18 months. Outcomes will be analysed using linear mixed models.Ethics and disseminationEthical approval was obtained from the Medical Ethics Committee Zuyderland-Zuyd Heerlen, the Netherlands (METCZ20180131). Results will be published in peer-reviewed journals and will be presented at national and international conferences.Trial registration numberClinicalTrials.gov Registry (NCT04127383).

scholarly journals The impact of e-Health interventions on promoting Self-Care in Chronic Patients: an Umbrella Review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Renzi ◽  
G Gasperini ◽  
V Baccolini ◽  
C Marzuillo ◽  
C De Vito ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Chronic Conditions ◽  
Self Care ◽  
Health Interventions ◽  
Self Management ◽  
Improve Quality ◽  
Umbrella Review ◽  
Copd Patients

Abstract Background Promoting self-care is one of the most promising strategies to manage people with chronic conditions and to improve the Public Health System resilience. In this context, the use of e-Health could facilitate self-care promotion, assure continuity of care and save time. Methods We performed an umbrella review on Cochrane, Scopus, Medline, PsychInfo, CINAHL to analyse e-Health self-care promoting intervention in patients with Type- 2 Diabetes Mellitus (T2DM), Cardiovascular Diseases (CVD) and Chronic Obstructive Pulmonary Disease (COPD) compared to traditional intervention. AMSTAR-2 was used for quality appraisal. Results 10 systematic reviews were included for an amount of 376 RCTs and 3 quasi-experimental studies. All the e-Health interventions retrieved were categorized in 4 subgroups: Phone Reminder, Telemonitoring, Psychoeducational intervention supported by PCs/Apps and Combined Intervention. Nurses (271/379 studies) and physicians (149/379 studies) were the healthcare workers mostly involved in the administration of e-Health interventions. T2DM (5 reviews; 175 studies) and CVD (7 reviews; 164 studies) patients gained more progresses in self-management than COPD patients (3 reviews; 8 studies). E-Health appeared effective both in promoting self-management and disease awareness. Globally, all the e-Health interventions seemed to improve Quality of Life and clinical outcomes. Phone reminders were most effective to increase Medication Adherence. All Causes Mortality registered a positive effect through Telemonitoring. Hospital Admission and Cost-Efficacy were explored only by telemonitoring and it did not show differences with traditional intervention. Conclusions E-Health is an effective strategy to promote self-care in patients with chronic conditions and to improve quality of life and clinical outcomes. Further research is required to test e-Health intervention in COPD patients and to examine if there is different efficacy among e-Health subgroups. Key messages E-Health should be integrated in Primary Care strategies to improve Public Health systems resilience. Nurses, as frontline Primary Health Care workers, should be advised for e-Health administration.

scholarly journals Evaluating the Effect of Knowledge, Attitude, and Practice on Self-Management in Type 2 Diabetic Patients on Dialysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Shima Ghannadi ◽  
Atieh Amouzegar ◽  
Parisa Amiri ◽  
Ronak Karbalaeifar ◽  
Zhale Tahmasebinejad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Microvascular Complications ◽  
Glycosylated Hemoglobin ◽  
Self Care ◽  
Self Management ◽  
Diabetic Patients ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Background.Type 2 diabetes is an increasingly common condition with several preventable microvascular complications such as kidney damage. Nephropathy is expensive to manage, especially as hospital dialysis treatment. Improving patients’ knowledge, attitude, and practice (KAP) toward their condition can achieve better control, delay complications, and improve their quality of life. This study evaluated the KAP and self-care behaviors of diabetic patients on dialysis and variables that affect it.Methods.This cross-sectional study was conducted at Shahid Beheshti academic hospitals of Tehran, Iran. Face-to-face interviews were held to fill five validated questionnaires: three evaluating KAP, one evaluating self-management, and one evaluating quality of life.Result.117 diabetic patients on hemodialysis (42 females) with mean (SD) age of68.70±9.26years were enrolled in the survey. The scores for patient’s KAP, self-care, and quality of life were59.90±11.23,44.27±8.35,45.06±12.87,46.21±10.23, and26.85±13.23, respectively. There was significant negative correlation between patients’ knowledge and attitude with their glycosylated hemoglobin level and their fasting blood sugar. There was significant correlation between patients’ knowledge and practice with their self-care activities.Conclusion.The present study suggests that patients’ KAP scores have a practical effect upon self-care behavior. This highlights the needs for effective diabetes education programs in developing countries like Iran.

scholarly journals Effect of diabetes self-management education on glycaemic control among type 2 diabetic patients at a family medicine clinic in Kenya: A randomised controlled trial

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Catherine W. Gathu ◽  
Jacob Shabani ◽  
Nancy Kunyiha ◽  
Riaz Ratansi
Keyword(s):  
Family Medicine ◽  
Usual Care ◽  
Primary Outcome ◽  
Self Management ◽  
Diabetic Patients ◽  
Educational Approach ◽  
Medicine Clinic ◽  
The Family

Background: Diabetes self-management education (DSME) is a key component of diabetes care aimed at delaying complications. Unlike usual care, DSME is a more structured educational approach provided by trained, certified diabetes educators (CDE). In Kenya, many diabetic patients are yet to receive this integral component of care. At the family medicine clinic of the Aga Khan University Hospital (AKUH), Nairobi, the case is no different; most patients lack education by CDE.Aim: This study sought to assess effects of DSME in comparison to usual diabetes care by family physicians.Setting: Family Medicine Clinic, AKUH, Nairobi.Methods: Non-blinded randomised clinical trial among sub-optimally controlled (glycated haemoglobin (HbA1c) ≥ 8%) type 2 diabetes patients. The intervention was DSME by CDE plus usual care versus usual care from family physicians. Primary outcome was mean difference in HbA1c after six months of follow-up. Secondary outcomes included blood pressure and body mass index.Results: A total of 220 diabetes patients were screened out of which 140 met the eligibility criteria and were randomised. Around 96 patients (69%) completed the study; 55 (79%) in the DSME group and 41 (59%) in the usual care group. The baseline mean age and HbA1c of all patients were 48.8 (standard deviation [SD]: 9.8) years and 9.9% (SD: 1.76%), respectively. After a 6-month follow-up, no significant difference was noted in the primary outcome (HbA1c) between the two groups, with a mean difference of 0.37 (95% confidence interval: -0.45 to 1.19; p = 0.37). DSME also made no remarkable change in any of the secondary outcome measures.Conclusion: From this study, short-term biomedical benefits of a structured educational approach seemed to be limited. This suggested that offering a short, intensified education programme might have limited additional benefit above and beyond the family physicians’ comprehensive approach in managing chronic conditions like diabetes.

scholarly journals Education for type 2 diabetes mellitus self-care: from compliance to empowerment

2009 ◽  
Vol 13 (30) ◽  
pp. 93-106 ◽  
Author(s):  
Antonio Pithon Cyrino ◽  
Lilia Blima Schraiber ◽  
Ricardo Rodrigues Teixeira
Keyword(s):  
Social Sciences ◽  
Chronic Conditions ◽  
Self Care ◽  
Self Management ◽  
Degenerative Diseases ◽  
Cognitive Autonomy ◽  
The Social ◽  
Transmission Of Information ◽  
Traditional Approaches

Through a critical review of the literature on education for diabetes self-care and self-management, it was sought to point out the inappropriateness of traditional approaches towards compliance with treatment and transmission of information, considering the complexity of self-care under chronic conditions. The influence of the social sciences on the field of studies on chronic degenerative diseases in general, and diabetes in particular, was explored. From this perspective, it can be recognized that the fields of anthropology and sociology have been incorporated into research focusing more on individuals as patients, and on the experience gained through this process. Recently, there has been a slight change within the field of health education research relating to diabetes, with the introduction of strategies that seek to value the experience and autonomy of patients as self-care agents. This paper discusses the strategy for empowerment in education for diabetes self-care and self-management, as a dialogue-focused practice that respects patients' moral and cognitive autonomy.

scholarly journals Predictors of Diabetes Self-Management Behaviors in Type 2 Diabetes Patients

2021 ◽  
Author(s):  
Golnaz Azami ◽  
Soh Kim Lam ◽  
Sazlina Shariff-Ghazali ◽  
Salmiah Mohd Said ◽  
Sanaz Aazami ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 2 Diabetes ◽  
Linear Regression Analysis ◽  
Self Management ◽  
P Value ◽  
Efficacy Expectation ◽  
The Mean ◽  
Management Behaviors

Objective: Type 2 diabetes mellitus (T2DM) is a chronic condition that requires consistent medical care to help control glycemic indices. Diabetes self-management is found to be essential for optimal glycemic control. This study aimed to investigate the predictors of diabetes self-management in adult with T2DM. Materials and Methods: A cross-sectional study was conducted. A purposive sample of 142 adults with T2DM attended an outpatient endocrine clinic in an academic hospital in Ilam, Iran was invited to participate in this study from September to October 2016. The data were collected using a combination of validated questionnaires and the blood sample. IBM SPSS software version 22 used to conduct the analysis. Hierarchical linear regression analysis with the stepwise method was used to explore the predictors of diabetes self-management.  Results: The mean age of participants was 54.2 ± (11.8) years. The mean duration of diabetes was 8.9 ± (7.4). Hierarchical linear regression analysis determined that self-management behaviors had positive relationship with efficacy expectation (B= 0.445, P-value< 0.01), quality of life (B= 0.222, P-value= 0.02), and has a negative relationship with HbA1c (B= -0.194, P-value= 0.01).  Conclusion: The result of our study indicate that better diabetes self-management behaviors can be predicted by higher efficacy expectation, the better quality of life and lower HbA1c levels. Future interventions should focus on enhancing efficacy expectation, quality of life and optimizing glycemic control to improve self-management of diabetes.

Deprescribing in mental health: pragmatic steps for a better quality of life

2021 ◽  
Vol 3 (2) ◽  
pp. 60-66
Author(s):  
Nana Tomova ◽  
Ami Hale ◽  
Michelle Kruschandl
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Adverse Effects ◽  
Chronic Conditions ◽  
Adverse Reactions ◽  
Hospital Admissions ◽  
Medication Reviews ◽  
The Uk ◽  
Specialist Pharmacist

Half of the UK population take at least one prescribed medicine, while a quarter take three or more. Polypharmacy has become increasingly common, with the average number of items prescribed per person per year in England having increased by 53.8% in the last decade. Patients are prescribed, and may continue taking, medicines that cause adverse effects and where the harm of the medicine outweighs the benefit. Adverse reactions to medicines are connected to 6.5% of hospital admissions. Patients admitted with one drug side effect are more than twice as likely to be admitted with another. Deprescribing is the optimisation of medication and is a vital part of improving outcomes, managing chronic conditions, and avoiding adverse effects. The goal of deprescribing is to lessen medication burden and enhance quality of life. This article presents case studies from clinical practice in a mental health service, and highlights the merits of specialist pharmacist-led interventions with respects to medication reviews and deprescribing.

A Randomized Trial of a Church-Based Diabetes Self-management Program for African Americans With Type 2 Diabetes

2009 ◽  
Vol 35 (3) ◽  
pp. 439-454 ◽  
Author(s):  
Carmen D. Samuel-Hodge ◽  
Thomas C. Keyserling ◽  
Sola Park ◽  
Larry F. Johnston ◽  
Ziya Gizlice ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Management Program ◽  
Self Management ◽  
Individual Counseling ◽  
Related Quality ◽  
The Difference ◽  
Design And Methods ◽  
To Receive

Purpose This study developed and tested a culturally appropriate, church-based intervention to improve diabetes self-management. Research Design and Methods This was a randomized trial conducted at 24 African American churches in central North Carolina. Churches were randomized to receive the special intervention (SI; 13 churches, 117 participants) or the minimal intervention (MI; 11 churches, 84 participants). The SI included an 8-month intensive phase, consisting of 1 individual counseling visit, 12 group sessions, monthly phone contacts, and 3 encouragement postcards, followed by a 4-month reinforcement phase including monthly phone contacts. The MI received standard educational pamphlets by mail. Outcomes were assessed at 8 and 12 months; the primary outcome was comparison of 8-month A1C levels. Results At baseline, the mean age was 59 years, A1C 7.8%, and body mass index 35.0 kg/m2; 64% of participants were female. For the 174 (87%) participants returning for 8-month measures, mean A1C (adjusted for baseline and group randomization) was 7.4% for SI and 7.8% for MI, with a difference of 0.4% (95% confidence interval [CI], 0.1-0.6, P = .009). In a larger model adjusting for additional variables, the difference was 0.5% (95% CI, 0.2-0.7, P < .001). At 12 months, the difference between groups was not significant. Diabetes knowledge and diabetes-related quality of life significantly improved in the SI group compared with the MI group. Among SI participants completing an acceptability questionnaire, intervention components and materials were rated as highly acceptable. Conclusions The church-based intervention was well received by participants and improved short-term metabolic control.

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