TY - JOUR T1 - Effectiveness of an intervention to improve diabetes self-management on clinical outcomes in patients with low educational level JO - Gaceta Sanitaria T2 - AU - Olry de Labry Lima,Antonio AU - Bermúdez Tamayo,Clara AU - Pastor Moreno,Guadalupe AU - Bolívar Muñoz,Julia AU - Ruiz Pérez,Isabel AU - Johri,Mira AU - Quesada Jiménez,Fermín AU - Cruz Vela,Pilar AU - de los Ríos Álvarez,Ana M. AU - Prados Quel,Miguel Ángel AU - Moratalla López,Enrique AU - Domínguez Martín,Susana AU - Lopez de Hierro,José Andrés AU - Ricci Cabello,Ignacio SN - 02139111 M3 - 10.1016/j.gaceta.2016.05.017 DO - 10.1016/j.gaceta.2016.05.017 UR - https://www.gacetasanitaria.org/es-effectiveness-an-intervention-improve-diabetes-articulo-S0213911116301236 AB - ObjectiveTo determine whether an intervention based on patient-practitioner communication is more effective than usual care in improving diabetes self-management in patients with type 2 diabetes with low educational level. Methods12-month, pragmatic cluster randomised controlled trial. Nine physicians and 184 patients registered at two practices in a deprived area of Granada (Andalusia, Spain) participated in the study. Adult patients with type 2 diabetes, low educational level and glycated haemoglobin (HbA1c) > 7% (53.01 mmol/mol) were eligible. The physicians in the intervention group received training on communication skills and the use of a tool for monitoring glycaemic control and providing feedback to patients. The control group continued standard care. The primary outcome was difference in HbA1c after 12 months. Dyslipidaemia, blood pressure, body mass index and waist circumference were also assessed as secondary outcomes. Two-level (patient and provider) regression analyses controlling for sex, social support and comorbidity were conducted. ResultsThe HbA1c levels at 12 months decreased in both groups. Multilevel analysis showed a greater improvement in the intervention group (between-group HbA1c difference= 0.16; p=0.049). No statistically significant differences between groups were observed for dyslipidaemia, blood pressure, body mass index and waist circumference. ConclusionsIn this pragmatic study, a simple and inexpensive intervention delivered in primary care showed a modest benefit in glycaemic control compared with usual care, although no effect was observed in the secondary outcomes. Further research is needed to design and assess interventions to promote diabetes self-management in socially vulnerable patients. ER -