Telecare motivational interviewing for diabetes patient education and support : a randomised controlled trial based in primary care comparing nurse and peer supporter delivery
Dale, Jeremy, 1958-, Caramlau, Isabela, Docherty, Andrea, Sturt, Jackie and Hearnshaw, Hilary. (2007) Telecare motivational interviewing for diabetes patient education and support : a randomised controlled trial based in primary care comparing nurse and peer supporter delivery. Trials, Vol.8 . Article number 18. ISSN 1745-6215
WRAP_sturt_Telecare_motivational.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Official URL: http://dx.doi.org/10.1186/1745-6215-8-18
Background: There is increasing interest in developing peer-led and 'expert patient'-type interventions, particularly to meet the support and informational needs of those with long term conditions, leading to improved clinical outcomes, and pressure relief on mainstream health services. There is also increasing interest in telephone support, due to its greater accessibility and potential availability than face to face provided support. The evidence base for peer telephone interventions is relatively weak, although such services are widely available as support lines provided by user groups and other charitable services.
Methods/Design: In a 3-arm RCT, participants are allocated to either an intervention group with Telecare service provided by a Diabetes Specialist Nurse (DSN), an intervention group with service provided by a peer supporter (also living with diabetes), or a control group receiving routine care only. All supporters underwent a 2-day training in motivational interviewing, empowerment and active listening skills to provide telephone support over a period of up to 6 months to adults with poorly controlled type 2 diabetes who had been recommended a change in diabetes management (i.e. medication and/or lifestyle
changes) by their general practitioner (GP). The primary outcome is self-efficacy; secondary outcomes include HbA1c, total and HDL cholesterol, blood pressure, body mass index, and adherence to treatment. 375 participants (125 in each arm) were sought from GP practices across West Midlands, to detect a difference in self-efficacy scores with an effect size of 0.35, 80% power, and 5% significance level. Adults
living with type 2 diabetes, with an HbA1c > 8% and not taking insulin were initially eligible. A protocol
change 10 months into the recruitment resulted in a change of eligibility by reducing HbA1c to > 7.4%. Several qualitative studies are being conducted alongside the main RCT to describe patient, telecare supporter and practice nurse experience of the trial.
Discussion and implications of the research: With its focus on self-management and telephone peer support, the intervention being trialled has the potential to support improved self-efficacy and patient experience, improved clinical outcomes and a reduction in diabetes-related complications.
|Item Type:||Journal Article|
|Subjects:||R Medicine > R Medicine (General)|
|Divisions:||Faculty of Medicine > Warwick Medical School|
|Library of Congress Subject Headings (LCSH):||Diabetes, Telecommunications in medicine, Peer counseling|
|Journal or Publication Title:||Trials|
|Publisher:||BioMed Central Ltd.|
|Official Date:||28 June 2007|
|Article Number:||Article number 18|
|Access rights to Published version:||Open Access|
1. Barlow JH, Turner A, Wright CC: A randomised controlled
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