Low attendance at structured education for people with newly diagnosed type 2 diabetes: General practice characteristics and individual patient factors predict uptake

PATIENT EDUCATION AND COUNSELING

卷:99

Article

Winkley, Kirsty^1,2  Stahl, Daniel^2,3  Chamley, Mark⁴  Stopford, Rosanna^1,2  Boughdady, Monica^5,6  Thomas, Stephen⁷  Amiel, Stephanie A.^5,6  Forbes, Angus^8,9  Ismail, Khalida^1,2 

[1] Kings Coll London, Dept Psychol Med, London SE5 9RJ, England

[2] Inst Psychiat Psychol & Neurosci, London SE5 9RJ, England

[3] Kings Coll London, Dept Biostat, London SE5 9RJ, England

[4] Crown Dale Med Ctr, Lambeth Diabet Clin Lead, London, England

[5] Kings Coll London, Dept Diabet & Nutr, London SE5 9RJ, England

[6] Sch Med, London, England

[7] Guys & St Thomas NHS Fdn Trust, Dept Endocrinol & Diabet, London, England

[8] Kings Coll London, Dept Primary & Intermediate Care, London SE5 9RJ, England

[9] Nightingale Sch Nursing & Midwifery, London, England

关键词: Type 2 diabetes mellitus;    General practice;    Primary health care;    Education;    Attendance;    Uptake;   

DOI  :  10.1016/j.pec.2015.08.015

来源: Elsevier

【 摘 要 】

Objective: The aims were to determine the association between individual and neighbourhood factors and attendance at structured education amongst people with newly diagnosed type 2 diabetes (T2DM). Methods: Multi-level analysis of questionnaire data from a prospective cohort of adults newly diagnosed T2DM. Setting was primary care, London, UK. Main outcome was attendance at structured education within 2 years. Results: Of 1790 people recruited, attendance data were available for 1626 (91%). Only 22.4% (n=365/1626) attended education. Attendance was independently associated with female gender (OR 1.28,95% Cl 1.05-1.46), lower HbA1c (OR 0.98 mmol/mol 95% CI 0.97-0.99) and non-smoker status (OR 1.36, 95% CI 1.07-1.55). General practice covariates, achievement of primary care targets for glycaemic control (OR 1.05, 95% C.I. 1.01-1.08) and recording of retinal screening (OR 0.96, 95% C.I. 0.93-0.99) were independently associated with attendance but unexplained general practice clustering accounted for 17% of the variance. Conclusion: Education uptake is low amongst people with new onset T2DM. Attenders are more likely to be female, non-smokers with better HbA1c. General practices achieving glycaemic targets are more likely to have patients who attend education. Practice implications: Strategies are needed to improve attendance at structured diabetes education particularly amongst hard to reach groups. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

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