Embedding Diabetes Education (RCT)
Research type
Research Study
Full title
Evaluating the impact of an intervention to increase uptake of self-management education programmes for Type 2 Diabetes in primary care: A wait-list cluster randomised controlled trial
IRAS ID
238291
Contact name
Melanie Davies
Contact email
Sponsor organisation
University of Leicester
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Research Summary
Our study is part of a complex research project wanting to increase the number of people with type 2 diabetes who go to self-management education programmes.
Diabetes is a serious and progressive disease which can lead to complications like heart attacks, stroke, kidney failure, and a shorter span of life. Managing diabetes well is the key to living a healthy life and self-management education programmes are the best way to gain the knowledge and skills necessary to live well with diabetes. So our study is particularly relevant to anyone with diabetes, as well as the general public.
Our study is not about testing a particular diabetes education programme; very good evidence about these programmes already exists. We will be working with education providers, CCG staff (local NHS providers of primary healthcare) and 66 GP practices to improve the opportunities provided for people with diabetes to attend education programmes. We will offer a package of support and resources, the ‘Embedding Package’, developed in an earlier part of our research project. The Embedding package deals with a wide variety of needs, from training GPs and nurses in how to explain the benefits of diabetes education to improving the way that information about diabetes education is made available in local communities etc.. It also includes a skilled person we describe as an ‘Embedder’ to support both providers and practices with ideas and skills. We will collect information from patients with type 2 diabetes and healthcare staff through a variety of different methods, including a patient questionnaire, interviews and observations and pseudonymised electronic patient data. Through this data the study will assess the effectiveness, cost-effectiveness and sustainability of the Embedding Package in comparison to usual care.
Summary of Results
The problem Self-management education and support programmes help people with type 2 diabetes to better manage their diabetes. NHS and international guidelines recommended these programmes, but many people are not offered them and most do not attend.
What we did
We tried to increase attendance at type 2 diabetes self-management programmes.
We created a ‘package’ of practical solutions based on evidence about why some people are not offered programmes and why most do not attend. The package included a website with useful resources and a person to encourage organisations to use these resources. We also created a patient digital self-management programme (MyDESMOND) as another way to receive support.
We used the package in a small study and improved it based on what we learnt. We then carried out a large, thorough study to see whether the package worked and provided value-for-money.
What we found
Overall, the package did not increase attendance at self-management programmes or improve patient glucose levels. There were many reasons for this. For example, many organisations did not use the package.
However, there were improvements in glucose levels among people from ethnic minority backgrounds, who are generally less likely to access self-management programmes. Also, glucose levels and programme attendance improved when we looked at a longer time period than the main study, so it may take longer than we expected for the package to filter through into patient benefit. The package was very low cost (52p per person).
MyDESMOND was made freely available during the COVID-19 pandemic. Over 25,000 people accessed it, and it seemed to be of value to these people as their self-reported glucose levels improved.
What does this mean
This package is a starting point for helping more people with type 2 diabetes access support to manage their diabetes, but more work is needed.REC name
West Midlands - Edgbaston Research Ethics Committee
REC reference
18/WM/0036
Date of REC Opinion
22 Jan 2018
REC opinion
Favourable Opinion