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- Title
Diabetes self-management education is not associated with a reduction in long-term diabetes complications: an effectiveness study in an elderly population.
- Authors
Shah, Baiju R.; Hwee, Jeremiah; Cauch‐Dudek, Karen; Ng, Ryan; Victor, J. Charles
- Abstract
Rationale, aims and objectives The efficacy of diabetes self-management education on glycaemic control, self-care behaviour and knowledge has been established by short-term studies in experimental settings. The objective of this study was to assess its effectiveness to improve quality of care and reduce the risk of long-term diabetes complications in unselected older patients with recently diagnosed diabetes in routine clinical care. Methods Using population-level health care administrative databases and registries, all patients aged ≥66 years in Ontario, Canada with diabetes for <5 years were identified. Self-management education programme attendees ( n = 8485) in 2006 were matched with non-attendees using high-dimensional propensity scores, creating extremely well-balanced study arms. Quality of care measures and the long-term risk of diabetes complications were compared. Results Self-management programme attendees were more likely than non-attendees to achieve process measures of quality of care such as retinal screening examinations (75.3% versus 70.3%, adjusted relative risk 1.05, 99% confidence interval 1.03-1.08), and ≥2 glycated haemoglobin tests (57.5% versus 53.3%, adjusted relative risk 1.08, 99% confidence interval 1.05-1.11). However, with a median follow-up of 5.3 years, diabetes complications and mortality were not different between arms. Conclusions In real-world clinical care, self-management education for older patients with recently diagnosed diabetes was associated with modest improvements in quality of care, but no reductions in long-term clinical events.
- Subjects
ONTARIO; DIABETES complications; CONFIDENCE intervals; DIABETES; LONGITUDINAL method; EVALUATION of medical care; MEDICAL quality control; PATIENT education; REGRESSION analysis; RESEARCH funding; HEALTH self-care; EDUCATIONAL outcomes; PROPORTIONAL hazards models; DATA analysis software; DESCRIPTIVE statistics; OLD age
- Publication
Journal of Evaluation in Clinical Practice, 2015, Vol 21, Issue 4, p656
- ISSN
1356-1294
- Publication type
Article
- DOI
10.1111/jep.12360