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Effectiveness of group‐based self‐management education for individuals with Type 2 diabetes: a systematic review with meta‐analyses and meta‐regression
Author(s) -
OdgersJewell K.,
Ball L. E.,
Kelly J. T.,
Isenring E. A.,
Reidlinger D. P.,
Thomas R.
Publication year - 2017
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.13340
Subject(s) - medicine , waist , body mass index , type 2 diabetes , confidence interval , meta analysis , diabetes mellitus , psychosocial , psychological intervention , physical therapy , endocrinology , psychiatry
Aims Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self‐management behaviours. This systematic review aimed to determine the effectiveness of group‐based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes. Methods Six electronic databases were searched. Group‐based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA 1c ) and followed participants for ≥ 6 months were included. The primary outcome was HbA 1c , and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self‐efficacy. Results Fifty‐three publications describing 47 studies were included ( n = 8533 participants). Greater reductions in HbA 1c occurred in group‐based education compared with controls at 6–10 months [ n = 30 studies; mean difference ( MD ) = 3 mmol/mol (0.3%); 95% confidence interval ( CI ): −0.48, −0.15; P = 0.0002], 12–14 months [ n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI : −0.49, −0.17; P < 0.0001], 18 months [ n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI : −1.26, −0.18; P = 0.009] and 36–48 months [ n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI : −1.52, −0.34; P = 0.002], but not at 24 months. Outcomes also favoured group‐based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA 1c when compared with peer‐led interventions. Conclusions Group‐based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.