Patient activation reduces glycemic levels in type 2 diabetes
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Patient activation interventions — meant to increase a patient’s knowledge, skills and confidence to manage their health — had a significant and positive effect on glycemic levels and self-management behaviors among patients with type 2 diabetes, researchers reported.
Patient activation “differs from patient education in that patient education often refers to providing information to the patient by health professionals in a passive way, whereas patient activation refers to increasing patient’s knowledge and confidence and facilitates skills building where the patient plays an active role in decision-making,” Nasser Almutairi, MBBS, MPH, of the School of Health and Society at the University of Wollongong in Australia, and colleagues wrote in Primary Care Diabetes.
According to researchers, patient activation has been tied to improved HDL, BP and triglycerides levels. To see whether type 2 diabetes glycemic control can be added to the list, they systematically reviewed 10 randomized controlled trials published between 2004 and 2018. The trials included 3,728 patients (mean age, 57.3 years; mean BMI, 31.2 kg/m2) from the United States, South America, Asia and Europe. Some of the interventions that were studied included skills building, motivational interviewing, patient empowerment and patient-centered tailored care. The interventions were conducted individually or in group sessions, via in-person office visits and/or telehealth and lasted from 6 weeks to 24 months. Patient follow-up occurred up to 24 months after the intervention’s completion.
Almutairi and colleagues found that the different patient activation interventions demonstrated a significant reduction in HbA1c levels, which ranged from 0.36% to 0.8%. According to the researchers, that range is consistent with the American Diabetes Association and the European Association for the Study of Diabetes consensus statement for the medical management of hyperglycemia in type 2 diabetes. When patient follow-up occurred at 12 months, the combined mean change in HbA1c was 0.92 (3.86 to 0.02) for the intervention groups and 0.45 (3.69 to 0.2) for the control groups.
In addition, all of the interventions led to improvements in at least one self-management behavior, such as physical activity, self-monitoring of blood glucose, foot care and medication adherence, according to the researchers.
“Most of the studies showed mixed results in self-management behaviors,” Almutairi and colleagues wrote. “The complex nature of human behavior could be a plausible explanation of these heterogenous results.” – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.