RESEARCH STRATEGY Do (X-PERT) patient education programs for adults with type 2 Diabetes improve glycogenic control?



Research Strategy

Do (X-PERT) patient education programs for adults with type 2 Diabetes improve glycogenic control?

Research Strategy

Adults living in the UK, with Type 2 diabetes participated in a diabetes educational session based on an adapted version of the X-PERT® Programme. Participants attended a session, led by a trained peer educator and carried out in Sylheti. All participants who registered on the course were telephoned or visited in person the day before the course as a reminder.

Participants

Sixteen general medical practices, within Burnley, Pendle and Rossendale, Lancashire, UK were invited to take part in the study. Adults with Type 2 diabetes were identified from practice registers using the World Health Organization criteria. Housebound patients and those with reduced cognitive ability were excluded. Included patients received a patient information leaflet.

Randomization

Participants were randomized to intervention or control using random permuted blocks and sealed opaque envelopes.

Blinding

To maintain blind allocation, patient information leaflets stated that the study was to compare the effectiveness of an individual vs. group approach to diabetes education. Participants were therefore less likely to identify if they were in the intervention or control group. It was not possible to blind those delivering the interventions. Outcome assessments were carried out by a community nurse and a healthcare assistant blinded to treatment assignment.

Hypothesis

Primary care delivery of the patient-centred, structured diabetes education programme X-PERT for adults with Type 2 diabetes, based on theories of patient empowerment and discovery learning, develops skills and confidence leading to increased diabetes self-management and sustained improvements in clinical, lifestyle and psychosocial outcomes.

Interventions

In addition to routine care, the control group received diabetes education and review with prearranged individual appointments with a dietician (30 min), practice nurse (15 min) and general practitioner (10 min).

Members of the intervention group were invited to attend the X-PERT Programme. This involved six weekly sessions, each lasting 2 h. Sessions were held in community venues with an average of 16 participants plus four to eight carers in each programme. The programme aimed to develop skills and build confidence, to enable patients to make informed decisions regarding their diabetes self-care. The X-PERT Programme was designed and delivered by a diabetes research dietitian (T.A.D.) who took on the role of a diabetes educator. The community venues were easily accessible. Separate sessions were held for Urdu-speaking South Asian participants, where a translator was present. If participants failed to attend one ...