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The attitude of healthcare professionals plays an important role in the uptake of diabetes self‐management education: analysis of the Barriers to Uptake of Type 1 Diabetes Education ( BUD 1E) study survey
Author(s) -
Harris S. M.,
Joyce H.,
Miller A.,
Connor C.,
Amiel S. A.,
Mulnier H.
Publication year - 2018
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.13704
Subject(s) - medicine , attendance , educational attainment , health care , family medicine , population , gerontology , health professionals , diabetes mellitus , type 2 diabetes , diabetes management , nursing , environmental health , endocrinology , economics , economic growth
Aim To explore reasons for the poor uptake of accredited diabetes self‐management education ( DSME ) in adults with Type 1 diabetes. Methods The study was set in an urban population in South London, UK . A cross sectional survey gathered demographic, diabetes service‐use data, psychological scores and reasons for non‐attendance at locally‐available DSME . In addition, 56 healthcare professionals were surveyed. Results Responses to surveys were returned by 496 adults with Type 1 diabetes (33% response rate), of whom 263 had attended DSME (53%). Multivariable analysis adjusted for significant variables identified four key variables influencing attendance. Non‐attendance was associated with men ( OR 0.55 CI 0.37‐0.84, p = 0.005), lower educational attainment ( OR 0.45 CI 0.28‐0.73, p = 0.001), higher glycated haemoglobin ( OR 1.74 CI 1.03‐2.94, p = 0.04) and healthcare professional encouragement to attend ( OR 1.7 CI 1.28‐2.3, p = 0.001). The most frequently reported barriers to attendance were work (37%) and time (14%) commitments. Only 49% of healthcare professionals ( HCP s) correctly identified the most likely barriers. Those HCP s who had observed courses believed more in their efficacy, with higher uptake within their clinic population. Conclusions Social determinants of health, particularly educational attainment and gender, increase health inequalities by influencing decisions to attend evidence‐based education courses. Healthcare professional communication is paramount to encourage attendance, and observation of a course may facilitate this.