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The Effect of a Self-Management Oriented Education and Treatment Programme (PRIMAS) for Type 1 Diabetic Patients

  • Background and aims: In a randomised, multi-centre trial, the effect of a structured education and treatment programme to promote self-management and empowerment for type 1 diabetic patients (PRIMAS) was compared to an established education programme (Structured education and treatment programme for type 1 diabetic patients) as an active comparator condition (ACC). Besides optimizing insulin treatment by testing basal insulin doses and carbohydrate factors as well as avoiding acute and late complications the PRIMAS programme also aims at motivational factors and the daily routine of living with diabetes. Materials and methods: A total of 160 patients with type 1 diabetes recruited in diabetologist practices (PRIMAS: age 45.9 ±13.8 yrs, diabetes duration 19.6 ±12.8 yrs., 38.3% female, HbA1c 8.3 ±1.1%, 23.5% with CSII vs. ACC: age 45.2 ±13.4 yrs, diabetes duration 19.4 ±13.2 yrs., 49.4% female, HbA1c 8.1 ±0.9%, 27.8% with CSII) were randomised to either PRIMAS or the ACC. Main outcome was the HbA1c 6 months after participation inBackground and aims: In a randomised, multi-centre trial, the effect of a structured education and treatment programme to promote self-management and empowerment for type 1 diabetic patients (PRIMAS) was compared to an established education programme (Structured education and treatment programme for type 1 diabetic patients) as an active comparator condition (ACC). Besides optimizing insulin treatment by testing basal insulin doses and carbohydrate factors as well as avoiding acute and late complications the PRIMAS programme also aims at motivational factors and the daily routine of living with diabetes. Materials and methods: A total of 160 patients with type 1 diabetes recruited in diabetologist practices (PRIMAS: age 45.9 ±13.8 yrs, diabetes duration 19.6 ±12.8 yrs., 38.3% female, HbA1c 8.3 ±1.1%, 23.5% with CSII vs. ACC: age 45.2 ±13.4 yrs, diabetes duration 19.4 ±13.2 yrs., 49.4% female, HbA1c 8.1 ±0.9%, 27.8% with CSII) were randomised to either PRIMAS or the ACC. Main outcome was the HbA1c 6 months after participation in the respective programme. Secondary outcomes were diabetes related distress (Diabetes Distress Scale 17 items), extent of self-perceived empowerment (Empowerment scale 11 items), self-efficacy for diabetes management (Self-efficacy scale 10 items), diabetes knowledge (Knowledge test 11 items), and self-care behaviour (Summary of Diabetes Self Care Activity Scale). Baseline adjusted results are reported as mean ± SEM. Results: Baseline adjusted HbA1c was significantly more improved in PRIMAS than in the ACC (-0.33 ± 0.1% vs. -0.03 ± 0.1%, p=.028) at 6 month follow-up. Also patients treated with PRIMAS reported lower baseline adjusted diabetes related distress levels (mean item score 0.9 ± 0.1 vs. 1.1 ± 0.1, p=.049), higher empowerment (27.4 ± 0.5 vs. 26.0 ± 0.5 p=.027) and self-efficacy levels (mean score: 23.3 ± 0.4 vs. 21.9 ± 0.4 p=.044) than patients in the ACC. Satisfaction with insulin treatment was also higher after 6 month in PRIMAS than in the ACC (mean score: 27.1 ± 0.6 vs. 25.3 ± 0.6; p=.028). Effects on knowledge (mean score 7.7 ± 0.2 vs. 7.9 ± 0.2 p=.555) and self-care behaviours (mean score: 3.7 ± 0.1 vs. 3.8 ± 0.1; p=.846) did not differ significantly between the education programmes nor did insulin dose (0.66 ± 0.02 vs. 0.63 ± 0.02 IU/kg; p=.284). Conclusion: PRIMAS is more effective in lowering HbA1c than the established education programme in type 1 diabetic patients. In addition, PRIMAS has proven its efficacy regarding the improvement of empowerment, self-efficacy and satisfaction with insulin treatment as well as regarding the reduction of diabetes related distress. The effects on knowledge and self-care behaviour are similar to those of the established education programme. Thus, PRIMAS provides a good alternative for treatment and education of type 1 diabetic patients.show moreshow less

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Metadaten
Institutes:Fakultät Humanwissenschaften / Lehrstuhl für Klinische Psychologie/Psychotherapie
Author:Bernhard Kulzer, Norbert Hermanns, Dominic Ehrmann, Nikola Bergis, Thomas Haak
Contributing Corporation:EASD Annual Meeting of the European Association for the Study of Diabetes, 48, 2012, Berlin
Place of publication:Bamberg
Publisher:OPUS
Year of publication:2016
Pages / Size:1 pdf-Datei (1 S.)
Year of first publication:2012
Source/Other editions:Ursprünglich in: Diabetologia 55 (2012) Supplement 1, S. 408
Keywords:Education
URN:urn:nbn:de:bvb:473-opus4-463511
Document Type:Variety of texts
Language:English
Peer Review:Ja
Internationale Verbreitung:Ja
Embargo Date:2016/08/03
Publishing Institution:Otto-Friedrich-Universität Bamberg
Release Date:2016/07/04