Individualized intervention reduces diabetes distress, HbA1c in type 2 diabetes
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Key takeaways:
- Adults with type 2 diabetes had less diabetes distress after completing individually tailored education modules.
- The study group had reductions in HbA1c and body weight from baseline to after intervention.
HOUSTON — Most adults with type 2 diabetes were able to reduce their diabetes distress after completing a series of individually selected education modules led by a pharmacist, according to two speakers.
In findings presented at the Association of Diabetes Care & Education Specialists Annual Conference, researchers assigned adults with type 2 diabetes to participate in educational modules selected for them based on their baseline scores on the Diabetes Distress Scale. After completing the modules, participants reported experiencing less diabetes distress and had reductions in HbA1c and body weight.
“Diabetes distress is common in people with type 2 diabetes, including those achieving treatment goals,” Katelyn Parsons, PharmD, BCACP, clinical associate professor of ambulatory care and a board-certified ambulatory care pharmacist in the College of Pharmacy and Health Sciences at Western New England University, told Healio. “Routine screening and tailored education can help to reduce diabetes distress and improve glucose management.”
Parsons and colleagues recruited adults with type 2 diabetes during routine visits to participate in the study (mean age, 64.5 years; 50% women). HbA1c, body weight and demographics were collected at baseline, and participants completed the Diabetes Distress Scale and Patient Health Questionnaire. Participants were then assigned to required and optional education modules based on their responses to the baseline questionnaires.
“Depending on how participants scored on the four subscales of the Diabetes Distress Scale, they qualified for various educational modules based on the ADCES7 Self-Care Behaviors,” Parsons said. “Each of these modules was at least an hour visit with a pharmacist and concluded with setting SMART (specific, measurable, attainable, realistic and timely) goals for behavior change. This education could be implemented by any diabetes care and education specialist.”
HbA1c, body weight and the questionnaires were administered again after modules were completed. Participants also completed the Modified Diabetes Disease State Management Questionnaire and additional satisfaction questions at follow-up.
Diabetes distress, HbA1c improve
There were 53 adults who participated in the study, of whom 45 completed the post-intervention follow-up. Of the study population, 39.6% were identified as having diabetes distress based on their total score on the Diabetes Distress Scale, and 77.4% had at least a moderate level of distress on one or more subscales.
The 53 participants were assigned 141 modules, with 91.5% of those modules being completed. Adults were also permitted to complete 63 optional modules, of which 17.5% were completed.
Adults who completed the follow-up had a reduction in HbA1c (6.8% vs. 6.5%; P = .015), Patient Health Questionnaire score (1.6 vs. 1; P = .022) and body weight (219.8 lb vs. 216.4 lb; P = .031) from baseline to after intervention. Total score on the Diabetes Distress Scale declined from 2.1 at baseline to 1.7 after intervention (P = .003). Participants had reductions on the emotional burden (2.4 vs. 1.8; P = .001) and regimen distress (2.3 vs. 1.7; P < .001) subscales of the Diabetes Distress Scale from baseline to follow-up. The percentage of adults with at least moderate distress in one or more subscales dropped to 54.8% at follow-up.
“Study findings indicate that pharmacists and diabetes educators can positively impact diabetes management and emotional well-being through tailored education based on the ADCES7 Self-Care Behaviors,” Gladys Ekong, BPharm, PhD, assistant professor of pharmacy administration in the College of Pharmacy and Health Sciences at Western New England University, told Healio. “The research study can be adapted and implemented in other clinics. A team-based approach to care is encouraged for practice sites aiming to implement a similar study.”
Most participants very satisfied with intervention
Of 44 adults who completed the follow-up satisfaction questions, all but one said they would recommend the intervention to others, and satisfaction scores for the intervention according to the Modified Diabetes Disease State Management Questionnaire were 4.6 or higher of a possible five points on all subscales.
“The research team would like to assess the effectiveness of the intervention in a group setting, as this would be scalable,” Ekong said. “We encourage clinicians and researchers to identify mental health outcomes that are prevalent in their patient population and implement research interventions that target these areas of need.”
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Parsons KA, et al. S20A. Presented at: ADCES23; Aug. 4-7, 2023; Houston.
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