Increasing capacity to deliver diabetes self-management education

results of the DESMOND lay educator non-randomized controlled equivalence trial

M.E Carey, P Mandalia, H Daly, Laura Gray, R Hale, L Martin Stacey, Nick Taub, Timothy Skinner, Margaret Stone, S Heller, K Khunti, M.J Davies

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Aim: To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators.

    Methods: We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland.

    Results: The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels.

    Conclusion: Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education.
    Original languageEnglish
    Pages (from-to)1431-1438
    Number of pages8
    JournalDiabetic Medicine
    Volume31
    Issue number11
    DOIs
    Publication statusPublished - Nov 2014

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    Self Care
    Type 2 Diabetes Mellitus
    Education
    Outcome Assessment (Health Care)
    Delivery of Health Care
    Professional Education
    Scotland
    England
    Non-Randomized Controlled Trials
    Primary Health Care
    Organizations
    Costs and Cost Analysis
    Control Groups

    Cite this

    Carey, M.E ; Mandalia, P ; Daly, H ; Gray, Laura ; Hale, R ; Stacey, L Martin ; Taub, Nick ; Skinner, Timothy ; Stone, Margaret ; Heller, S ; Khunti, K ; Davies, M.J. / Increasing capacity to deliver diabetes self-management education : results of the DESMOND lay educator non-randomized controlled equivalence trial. In: Diabetic Medicine. 2014 ; Vol. 31, No. 11. pp. 1431-1438.
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    abstract = "Aim: To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators.Methods: We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland.Results: The 95{\%} CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95{\%} CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels.Conclusion: Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education.",
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    author = "M.E Carey and P Mandalia and H Daly and Laura Gray and R Hale and Stacey, {L Martin} and Nick Taub and Timothy Skinner and Margaret Stone and S Heller and K Khunti and M.J Davies",
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    Carey, ME, Mandalia, P, Daly, H, Gray, L, Hale, R, Stacey, LM, Taub, N, Skinner, T, Stone, M, Heller, S, Khunti, K & Davies, MJ 2014, 'Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial', Diabetic Medicine, vol. 31, no. 11, pp. 1431-1438. https://doi.org/10.1111/dme.12483

    Increasing capacity to deliver diabetes self-management education : results of the DESMOND lay educator non-randomized controlled equivalence trial. / Carey, M.E; Mandalia, P; Daly, H; Gray, Laura; Hale, R; Stacey, L Martin; Taub, Nick; Skinner, Timothy; Stone, Margaret; Heller, S; Khunti, K; Davies, M.J.

    In: Diabetic Medicine, Vol. 31, No. 11, 11.2014, p. 1431-1438.

    Research output: Contribution to journalArticleResearchpeer-review

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    AU - Gray, Laura

    AU - Hale, R

    AU - Stacey, L Martin

    AU - Taub, Nick

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    N2 - Aim: To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators.Methods: We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland.Results: The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels.Conclusion: Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education.

    AB - Aim: To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators.Methods: We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland.Results: The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels.Conclusion: Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education.

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