Structured patient education: the Diabetes X-PERT Programme makes a difference
Structured patient education: the Diabetes X-PERT Programme makes a difference
复制标题
DOI：
10.1111/j.1464-5491.2006.01906.x
复制
发表时间：
2006-09-01
影响因子：
3.5
通讯作者：
Greenwood, D. C.
中科院分区：
文献类型：
--
作者：
Deakin, T. A.;Cade, J. E.;Greenwood, D. C.
目的开发一个以病人为中心，以小组为基础的自我管理计划（X-PERT），基于授权和发现学习的理论，并评估该计划对临床，生活方式和心理社会outcomes.Methods成人2型糖尿病（n = 314），生活在伯恩利，彭德尔或罗森代尔，兰开夏郡，UK被随机分配到单独预约（对照组）（n = 157）或X-PERT程序（n = 157）。X-PERT患者被邀请参加6个2小时的自我管理教育小组会议。结果进行了评估，在基线，4和14 months.Results一百四十九名参与者（95%）参加了X-PERT计划，128（82%）参加四个或更多的会议。到14个月时，X-PERT组与对照组相比，平均HbA（1c）显著改善（- 0.6% vs. +0.1%，重复测量ANOVA，P < 0.001）。预防糖尿病药物增加需要治疗的人数（NNT）为4人[95%置信区间（CI）3，7]，减少糖尿病药物的NNT为7人（95% CI 5，11）。与对照患者相比，X-PERT患者的体重、体重指数（BMI）、腰围、总胆固醇、自我赋权、糖尿病知识、体力活动水平、足部护理、水果和蔬菜摄入量也显示出统计学显著改善，享受食物和治疗满意度。结论参与X-成人2型糖尿病患者的PERT计划在14个月时显示改善了血糖控制，降低了总胆固醇水平，体重，BMI和腰围，减少了对糖尿病药物的需求，增加了水果和蔬菜的消费，享受食物，糖尿病知识、自我赋权、自我管理技能和治疗满意度。
Aims To develop a patient-centred, group-based self-management programme (X-PERT), based on theories of empowerment and discovery learning, and to assess the effectiveness of the programme on clinical, lifestyle and psychosocial outcomes.Methods Adults with Type 2 diabetes (n = 314), living in Burnley, Pendle or Rossendale, Lancashire, UK were randomized to either individual appointments (control group) (n = 157) or the X-PERT Programme (n = 157). X-PERT patients were invited to attend six 2-h group sessions of self-management education. Outcomes were assessed at baseline, 4 and 14 months.Results One hundred and forty-nine participants (95%) attended the X-PERT Programme, with 128 (82%) attending four or more sessions. By 14 months the X-PERT group compared with the control group showed significant improvements in the mean HbA(1c) (- 0.6% vs. + 0.1%, repeated measures ANOVA, P < 0.001). The number needed to treat (NNT) for preventing diabetes medication increase was 4 [95% confidence interval (CI) 3, 7] and NNT for reducing diabetes medication was 7 (95% CI 5, 11). Statistically significant improvements were also shown in the X-PERT patients compared with the control patients for body weight, body mass index (BMI), waist circumference, total cholesterol, self-empowerment, diabetes knowledge, physical activity levels, foot care, fruit and vegetable intake, enjoyment of food and treatment satisfaction.Conclusions Participation in the X-PERT Programme by adults with Type 2 diabetes was shown at 14 months to have led to improved glycaemic control, reduced total cholesterol level, body weight, BMI and waist circumference, reduced requirement for diabetes medication, increased consumption of fruit and vegetables, enjoyment of food, knowledge of diabetes, self-empowerment, self-management skills and treatment satisfaction.