Patient-centered communication and shared decision making to reduce HbA1c levels of patients with poorly controlled type 2 diabetes mellitus - results of the cluster-randomized controlled DEBATE trial.
Aged
Communication
Decision Making, Shared
Decision Support Techniques
Diabetes Mellitus, Type 2
/ metabolism
Female
Germany
Glycated Hemoglobin
/ metabolism
Humans
Hypoglycemic Agents
/ therapeutic use
Life Style
Male
Middle Aged
Patient-Centered Care
/ methods
Physician-Patient Relations
Primary Health Care
Decision making
Diabetes mellitus type 2
Health communication
Health services research
Physician-patient relations
Quality of life
Journal
BMC family practice
ISSN: 1471-2296
Titre abrégé: BMC Fam Pract
Pays: England
ID NLM: 100967792
Informations de publication
Date de publication:
25 06 2019
25 06 2019
Historique:
received:
17
09
2018
accepted:
12
06
2019
entrez:
27
6
2019
pubmed:
27
6
2019
medline:
26
2
2020
Statut:
epublish
Résumé
Does an intervention designed to foster patient-centered communication and shared decision making among GPs and their patients with poorly controlled type 2 diabetes mellitus reduce the level of HbA1c. The DEBATE trial is a cluster-randomized controlled trial conducted in German primary care and including patients with type 2 diabetes mellitus having an HbA1c level of 8.0% (64 mmol/mol) or above at the time of recruitment. Data was measured before intervention (baseline, T0), 6-8 months (T1), 12-14 months (T2), 18-20 months (T3), and 24-26 months (T4) after baseline. Main outcome measure is the level of HbA1c. In both, the intervention and the control group the decline of the HbA1c level from T0 to T4 was statistically significant (- 0.67% (95% CI: - 0.80,-0.54%; p < 0.0001) and - 0.64% (95% CI: - 0.78, - 0.51%; p < 0.0001), respectively). However, there was no statistically significant difference between both groups. Although the DEBATE trial was not able to confirm effectiveness of the intervention tested compared to care as usual, the results suggest that patients with poorly controlled type 2 diabetes are able to improve their blood glucose levels. This finding may encourage physicians to stay on task to regularly approach this cohort of patients. The trial was registered at ISRCTN registry under the reference ISRCTN70713571 .
Sections du résumé
BACKGROUND
Does an intervention designed to foster patient-centered communication and shared decision making among GPs and their patients with poorly controlled type 2 diabetes mellitus reduce the level of HbA1c.
METHODS
The DEBATE trial is a cluster-randomized controlled trial conducted in German primary care and including patients with type 2 diabetes mellitus having an HbA1c level of 8.0% (64 mmol/mol) or above at the time of recruitment. Data was measured before intervention (baseline, T0), 6-8 months (T1), 12-14 months (T2), 18-20 months (T3), and 24-26 months (T4) after baseline. Main outcome measure is the level of HbA1c.
RESULTS
In both, the intervention and the control group the decline of the HbA1c level from T0 to T4 was statistically significant (- 0.67% (95% CI: - 0.80,-0.54%; p < 0.0001) and - 0.64% (95% CI: - 0.78, - 0.51%; p < 0.0001), respectively). However, there was no statistically significant difference between both groups.
CONCLUSIONS
Although the DEBATE trial was not able to confirm effectiveness of the intervention tested compared to care as usual, the results suggest that patients with poorly controlled type 2 diabetes are able to improve their blood glucose levels. This finding may encourage physicians to stay on task to regularly approach this cohort of patients.
TRIAL REGISTRATION
The trial was registered at ISRCTN registry under the reference ISRCTN70713571 .
Identifiants
pubmed: 31238871
doi: 10.1186/s12875-019-0977-9
pii: 10.1186/s12875-019-0977-9
pmc: PMC6593484
doi:
Substances chimiques
Glycated Hemoglobin A
0
Hypoglycemic Agents
0
hemoglobin A1c protein, human
0
Banques de données
ISRCTN
['ISRCTN70713571']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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