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Can diabetes professionals deliver psychological treatments to improve glycaemic control? A systematic review and meta-analysis

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Alam, Rahul, Sturt, Jackie, Lall, Ranjit and Winkley, Kirsty (2008) Can diabetes professionals deliver psychological treatments to improve glycaemic control? A systematic review and meta-analysis. In: The Society for Academic Primary Care: 37th Annual Scientific Meeting, Galway, Ireland, 08 - 11 Jul 2008. Published in: The Society for Academic Primary Care: 37th Annual Scientific Meeting, Galway, Ireland [Presented Papers] p. 110.

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Abstract

OBJECTIVE: To update a meta-analysis and determine the effectiveness of psychological interventions on glycaemic control measured by HbA(1c) and psychological status in type 2 diabetes and to compare effects when interventions are delivered by generalist clinicians compared to psychological specialists. METHODS: We used the original review protocol and searched the Cochrane central register of controlled trials, Medline, Embase, PsychLIT, and Google Scholar from February 2003 (end of previous review) to March 2007. We extracted data on the participants, interventions, delivery methods, comparison groups and outcome measures. RESULTS: 35 trials were reviewed and meta-analysis of 19 trials (n=1431), reporting HbA(1c) found a reduction in HbA(1c) by 0.54% (-0.32; 95% CI: -0.47 to -0.16). In nine trials (n=832) interventions were delivered by diabetes or general clinicians reducing HbA(1c) by 0.51% (-0.27; 95% CI: -0.50 to 0.04). In nine trials, interventions (n=561) were delivered by psychological specialists reducing HbA(1c) by 0.57% (-0.36; 95% CI: -0.61 to 0.12). Meta-analysis of 13 trials reporting psychological status found psychological status to be lower in the intervention groups -0.56 (95% CI: 1.00 to -0.13). Trial quality for the majority of studies remained poor. CONCLUSION: Our findings suggest that psychological and general clinicians are similarly effective in delivering psychological interventions, however, effect sizes for all clinicians have reduced since the earlier review. PRACTICE IMPLICATIONS: Psychological training opportunities for generalist clinicians could lead to wider availability of effective psychological care.

Item Type: Conference Item (Paper)
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Journal or Publication Title: The Society for Academic Primary Care: 37th Annual Scientific Meeting, Galway, Ireland [Presented Papers]
Publisher: SAPC
Official Date: 2008
Dates:
DateEvent
2008Published
Page Range: p. 110
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Conference Paper Type: Paper
Title of Event: The Society for Academic Primary Care: 37th Annual Scientific Meeting
Type of Event: Other
Location of Event: Galway, Ireland
Date(s) of Event: 08 - 11 Jul 2008

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