CHANGE IN METABOLIC CONTROL AND FUNCTIONAL STATUS AFTER HOSPITALIZATION - IMPACT OF PATIENT ACTIVATION INTERVENTION IN DIABETIC-PATIENTS

被引:105
作者
ROST, KM [1 ]
FLAVIN, KS [1 ]
COLE, K [1 ]
MCGILL, JB [1 ]
机构
[1] WASHINGTON UNIV, SCH MED, ST LOUIS, MO 63110 USA
关键词
D O I
10.2337/diacare.14.10.881
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To determine whether a short intervention to enhance patient information seeking and decision making during hospitalization results in improved metabolic control and functional status in patients with diabetes mellitus. Research Design and Methods: A randomized clinical trial was conducted in which control patients received a comprehensive 3-day evaluation and educational program, whereas experimental patients received a 45-min patient activation intervention and a 1-h self-administered booster in addition to the program. Metabolic control and functional status were measured at baseline and 4 mo postdischarge. Results: During their discharge discussions, experimental patients asked significantly more questions than control patients (7.4 vs. 3.0, P < .001) and 4 mo later reported significantly fewer physical limitations in activities of daily living than the control group (P = 0.02). Improvement in metabolic control was statistically significant only for experimental patients (P = 0.02), although their glycosylated hemoglobin levels were not significantly lower than control patients' at follow-up. The intervention did not diminish physician satisfaction with patient interactions, although it may have increased physician frustration with responsibilities that competed with patient care. Conclusions: These results suggest that the addition of a patient activation intervention to a comprehensive diabetes management program may substantially enhance physical functioning among adults with diabetes mellitus.
引用
收藏
页码:881 / 889
页数:9
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