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The Feasibility of Health Trainer Improved Patient Self-Management in Patients with Low Health Literacy and Poorly Controlled Diabetes: A Pilot Randomised Controlled Trial

Protheroe, Joanne; Rathod, Trishna; Bartlam, Bernadette; Rowlands, Gillian; Richardson, Gerry; Reeves, David

The Feasibility of Health Trainer Improved Patient Self-Management in Patients with Low Health Literacy and Poorly Controlled Diabetes: A Pilot Randomised Controlled Trial Thumbnail


Authors

Trishna Rathod

Bernadette Bartlam

Gillian Rowlands

Gerry Richardson

David Reeves



Abstract

Type 2 diabetes mellitus is most prevalent in deprived communities and patients with low health literacy have worse glycaemic control and higher rates of diabetic complications. However, recruitment from this patient population into intervention trials is highly challenging. We conducted a study to explore the feasibility of recruitment and to assess the effect of a lay health trainer intervention, in patients with low health literacy and poorly controlled diabetes from a socioeconomically disadvantaged population, compared with usual care. Methods. A pilot RCT comparing the LHT intervention with usual care. Patients with HbA1c > 7.5 (58?mmol/mol) were recruited. Baseline and 7-month outcome data were entered directly onto a laptop to reduce patient burden. Results. 76 patients were recruited; 60.5% had low health literacy and 75% were from the most deprived areas of England. Participants in the LHT arm had significantly improved mental health (p = 0.049) and illness perception (p = 0.040). The intervention was associated with lower resource use, better patient self-care management, and better QALY profile at 7-month follow-up. Conclusion. This study describes successful recruitment strategies for hard-to-reach populations. Further research is warranted for this cost-effective, relatively low-cost intervention for a population currently suffering a disproportionate burden of diabetes, to demonstrate its sustained impact on treatment effects, health, and health inequalities.

Citation

Protheroe, J., Rathod, T., Bartlam, B., Rowlands, G., Richardson, G., & Reeves, D. (2016). The Feasibility of Health Trainer Improved Patient Self-Management in Patients with Low Health Literacy and Poorly Controlled Diabetes: A Pilot Randomised Controlled Trial. Journal of Diabetes Research, 2016, Article 6903245. https://doi.org/10.1155/2016/6903245

Journal Article Type Article
Acceptance Date Sep 28, 2016
Publication Date Sep 28, 2016
Journal Journal of Diabetes Research
Print ISSN 2314-6745
Publisher Hindawi
Peer Reviewed Peer Reviewed
Volume 2016
Article Number 6903245
DOI https://doi.org/10.1155/2016/6903245
Publisher URL http://dx.doi.org/10.1155/2016/6903245