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Provision of structured diabetes information encourages activation amongst people with diabetes as measured by diabetes care process attainment: the WICKED Project
Author(s) -
Gillani S. M. R.,
Nevill A.,
Singh B. M.
Publication year - 2015
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12737
Subject(s) - medicine , diabetes mellitus , randomized controlled trial , psychological intervention , logistic regression , educational attainment , family medicine , gerontology , physical therapy , nursing , endocrinology , economics , economic growth
Background People with diabetes have better outcomes if they actively participate in their care. Patient‐focused interventions can be effective in activating patients. Yet there is no known trial to evaluate the impact of the provision of individualized diabetes‐specific information on patient activation and diabetes care outcomes. Methods In a randomized controlled trial, all people ( n = 14 559) with diabetes within the local health economy were recruited and cluster randomized into two groups with the active group mailed a structured personalized report containing information on all nine of their diabetes care processes, whereas the control group received standard care. Differences in their Failed Process Score ( FPS ) were compared at three months. Results At three months, the FPS score (1.25 ± 1.87 vs. 1.35 ± 1.97, P < 0.01) and the change in FPS score (0.48 ± 1.55 vs. 0.42 ± 1.49, P < 0.02) were significantly better in those mailed a structured personalized report. A dichotomized FPS score [good attainment ( GA ) vs. poorer attainment], was significantly better in those mailed ( χ 2 = 10.0, P < 0.05) and using a binary logistic regression analysis adjusting for all demographic factors and the baseline FPS , the relative effect of mailing compared with non‐mailing on three‐month GA category was OR 1.14 (95% CI 1.04–1.25, P < 0.01). Conclusions Provision of structured and individualized information to people with diabetes can positively influence the level of patient activation, promote better engagement and open the potential to improve other crucial diabetes outcomes.