medwireNews: Receiving a strong positive message about the value of diabetes self-management education (DSME) courses from a healthcare professional (HCP) significantly increases the chances of a patient attending such a course, UK data show.
By contrast, male gender and not having attended university were associated with a significantly lower likelihood of taking part in DSME, Sophie Harris (King’s College London) and colleagues report in Diabetic Medicine.
The researchers invited 1484 adults with type 1 diabetes to participate in the study. Of these, 496 (33%) completed a survey looking into the reasons for the poor uptake of DSME. Just over half (53%) of respondees had attended a DSME course.
The majority (70%) of participants who had not taken part in DSME had heard of it; only 4% had been referred but not attended.
People who had not received DSME were significantly more likely to be men (67 vs 50%), be from Black and minority ethnic groups than White (23 vs 13%), not be in employment (30 vs 15%), and had a significantly lower level of educational attainment than those who had received DSME. They were also significantly less likely to have received a positive message (score ≥3 on a scale of 1–5) about DSME (76 vs 88%).
Multivariate analysis, taking each of these significant factors into account, showed that men were a significant 45% less likely than women to attend DSME, while individuals with less than a university level of educational attainment were a significant 55% less likely to attend than those with a university education.
By contrast, participants with a glycated hemoglobin (HbA1c) of 7.5–9.0% were a significant 70% more likely to attend DSME than those with an HbA1c below 7.5%.
Receiving a positive message about DSME increased the likelihood for attendance by a significant 71% compared with receiving a less than positive message, and the researchers point out that there was a significant 1-point difference in median score between attendees (score=5) and non-attendees (score=4) when they were asked to rate the HCPs message about DSME.
“This illustrates the important role that good HCP communication plays in encouraging self-management in [long-term conditions],” Harris et al remark.
The most commonly reported barriers to attendance were work (37%) and time (14%) commitments, and low perceived benefit (12%), but only 49% of 56 HCPs surveyed correctly identified these factors “suggesting there is scope for improving HCPs’ understanding of the difficulties experienced by people with Type 1 diabetes,” say the authors.
The HCP survey also showed that DSME attendance rates were higher, and belief in the efficacy of the course greater among HCPs who had attended themselves, compared with those who had not.
Based on their findings the Harris and team therefore conclude: “HCPs may maximize their marketing potential by observing a local DSME course and attending training to recognize the most frequent barriers, including those related to communication skills for those with low educational attainment.”
By Laura Cowen
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