The effect of training GPs in motivational interviewing on incident cardiovascular disease and mortality in people with screen-detected diabetes. Results from the ADDITION-Denmark randomised trial.
cardiovascular diseases
diabetes mellitus
general practice
motivational interviewing
randomised control trial
Journal
BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531
Informations de publication
Date de publication:
2020
2020
Historique:
received:
03
10
2019
accepted:
08
11
2019
pubmed:
20
2
2020
medline:
20
2
2020
entrez:
20
2
2020
Statut:
epublish
Résumé
There is no long-term evidence on the effectiveness of training for motivational interviewing in diabetes treatment. Within a trial of intensive treatment of people with screen-detected diabetes, which included training in motivational interviewing for GPs, the study examined the effect of the intervention on incident cardiovascular disease (CVD) and all-cause mortality. In the ADDITION-Denmark trial, 181 general practices were cluster randomised in a 2:1:1 ratio to: (i) to screening plus routine care of individuals with screen-detected diabetes (control group); (ii) screening plus training and support in intensive multifactorial treatment of individuals with screen-detected diabetes (intensive treatment group); or (iii) screening plus training and support in intensive multifactorial treatment and motivational interviewing for individuals with screen-detected diabetes (intensive treatment plus motivational interviewing group). The study took place from 2001-2009. After around 8 years follow-up, rates of first fatal and non-fatal CVD events and all-cause mortality were compared between screen-detected individuals in the three treatment groups. Compared with the routine care group, the risk of CVD was similar in the intensive treatment group (hazard ratio [HR] 1.11, 95% confidence interval [CI] = 0.82 to 1.50) and the intensive treatment plus motivational interviewing group (HR 1.26, 95% CI = 0.96 to 1.64). The incidence of death was similar in all three treatment groups. Training of GPs in intensive multifactorial treatment, with or without motivational interviewing, was not associated with a reduction in mortality or CVD among those with screen-detected diabetes.
Sections du résumé
BACKGROUND
BACKGROUND
There is no long-term evidence on the effectiveness of training for motivational interviewing in diabetes treatment.
AIM
OBJECTIVE
Within a trial of intensive treatment of people with screen-detected diabetes, which included training in motivational interviewing for GPs, the study examined the effect of the intervention on incident cardiovascular disease (CVD) and all-cause mortality.
DESIGN & SETTING
METHODS
In the ADDITION-Denmark trial, 181 general practices were cluster randomised in a 2:1:1 ratio to: (i) to screening plus routine care of individuals with screen-detected diabetes (control group); (ii) screening plus training and support in intensive multifactorial treatment of individuals with screen-detected diabetes (intensive treatment group); or (iii) screening plus training and support in intensive multifactorial treatment and motivational interviewing for individuals with screen-detected diabetes (intensive treatment plus motivational interviewing group). The study took place from 2001-2009.
METHOD
METHODS
After around 8 years follow-up, rates of first fatal and non-fatal CVD events and all-cause mortality were compared between screen-detected individuals in the three treatment groups.
RESULTS
RESULTS
Compared with the routine care group, the risk of CVD was similar in the intensive treatment group (hazard ratio [HR] 1.11, 95% confidence interval [CI] = 0.82 to 1.50) and the intensive treatment plus motivational interviewing group (HR 1.26, 95% CI = 0.96 to 1.64). The incidence of death was similar in all three treatment groups.
CONCLUSION
CONCLUSIONS
Training of GPs in intensive multifactorial treatment, with or without motivational interviewing, was not associated with a reduction in mortality or CVD among those with screen-detected diabetes.
Identifiants
pubmed: 32071038
pii: bjgpopen20X101012
doi: 10.3399/bjgpopen20X101012
pmc: PMC7330202
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright © 2020, The Authors.
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