TY - JOUR
T1 - Reducing resistance to treatment, through group intervention, improves clinical measurements in patients with type 2 diabetes
AU - Valinsky, Liora
AU - Mishali, Moshe
AU - Endevelt, Ronit
AU - Preiss, Rachel
AU - Dopelt, Keren
AU - Heymann, Anthony D.
N1 - Funding Information:
We declare hereby that in the past five years we did not received any reimbursements, fees, funding, or salary from an organization that may in any way gain or lose financially from the publication of this manuscript, either now or in the future. We hereby declare that none of us hold any stocks or shares in an organization that may in any way gain or lose financially from the publication of this manuscript, either now or in the future. We hereby declare that none of us hold or are currently applying for any patents relating to the content of the manuscript. We hereby declare that none of us received reimbursements, fees, funding, or salary from an organization that holds or has applied for patents relating to the content of the manuscript. We hereby declare that none of us has any other financial competing interests. We hereby declare that none of us has any non-financial competing interests (political, personal, religious, ideological, academic, intellectual, commercial or any other) in relation to this manuscript. This study was funded by a grant from The Maccabi Institute for Health Services Research.
PY - 2013/12/28
Y1 - 2013/12/28
N2 - Background: Studies have shown that group Therapeutic Patient Education (TPE) may empower patients with type 2 diabetes to better manage their disease. The mechanism of these interventions is not fully understood. A reduction in resistance to treatment may explain the mechanism by which TPE empowers participants to improve self-management. The Objective of this study was to examine the effectiveness of diabetes groups in reducing resistance to treatment and the association between reduced resistance and better management of the disease.Methods: In a program evaluation study, we administered validated questionnaires to measure resistance to treatment (RTQ) in 3 time periods: before the intervention (T1), immediately after the intervention (T2) and six months later (T3). Clinical measures (HbA1C, blood pressure, HDL, LDL and total cholesterol, Triglycerides and BMI) were retrieved from Maccabi Healthcare Services computerized systems, for T1;T2 and a year post intervention (T3). Linear mixed models were used adjusting for age, gender, social support and family status.Results: 157; 156 and 106 TPE participants completed the RTQ in T1; T2 and T3 respectively. HbA1C and systolic and diastolic blood pressure were significantly reduced in the group which achieved a reduction in three out of the five RTQ components. For the other clinical measurements no significant changes were observed.Conclusion: Our findings suggest that reducing resistance to treatment, through an educational program for patients with diabetes, is associated with a better disease control. Identifying patients with higher resistance to treatment, and including components that reduce resistance in patient education programs, have the potential to increase the effectiveness of these programs.
AB - Background: Studies have shown that group Therapeutic Patient Education (TPE) may empower patients with type 2 diabetes to better manage their disease. The mechanism of these interventions is not fully understood. A reduction in resistance to treatment may explain the mechanism by which TPE empowers participants to improve self-management. The Objective of this study was to examine the effectiveness of diabetes groups in reducing resistance to treatment and the association between reduced resistance and better management of the disease.Methods: In a program evaluation study, we administered validated questionnaires to measure resistance to treatment (RTQ) in 3 time periods: before the intervention (T1), immediately after the intervention (T2) and six months later (T3). Clinical measures (HbA1C, blood pressure, HDL, LDL and total cholesterol, Triglycerides and BMI) were retrieved from Maccabi Healthcare Services computerized systems, for T1;T2 and a year post intervention (T3). Linear mixed models were used adjusting for age, gender, social support and family status.Results: 157; 156 and 106 TPE participants completed the RTQ in T1; T2 and T3 respectively. HbA1C and systolic and diastolic blood pressure were significantly reduced in the group which achieved a reduction in three out of the five RTQ components. For the other clinical measurements no significant changes were observed.Conclusion: Our findings suggest that reducing resistance to treatment, through an educational program for patients with diabetes, is associated with a better disease control. Identifying patients with higher resistance to treatment, and including components that reduce resistance in patient education programs, have the potential to increase the effectiveness of these programs.
KW - Diabetes mellitus
KW - Empowerment
KW - Family support
KW - Resistance to treatment
KW - Self-help groups
UR - http://www.scopus.com/inward/record.url?scp=84890992559&partnerID=8YFLogxK
U2 - 10.1186/1472-6823-13-61
DO - 10.1186/1472-6823-13-61
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AN - SCOPUS:84890992559
SN - 1472-6823
VL - 13
JO - BMC Endocrine Disorders
JF - BMC Endocrine Disorders
M1 - 61
ER -
