The impact of patient-centred versus didactic education programmes in chronic patients by severity: the case of type 2 diabetes mellitus

Windrum, Paul and García-Goñi, Manuel and Coad, Holly (2016) The impact of patient-centred versus didactic education programmes in chronic patients by severity: the case of type 2 diabetes mellitus. Value in Health, 19 (4). pp. 353-362. ISSN 1524-4733

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Abstract

Background

Education leads to better health-related decisions and protective behaviors, being especially important for patients with chronic conditions. Self-management education programs have been shown to be beneficial for patients with different chronic conditions and to have a higher impact on health outcomes than does didactic education.

Objective

To investigate improvements in glycemic control (measured by glycated hemoglobin A1c) in patients with type 2 diabetes mellitus.

Methods

Our comparative trial involved one group of patients receiving patient-centered education and another receiving didactic education. We dealt with selection bias issues, estimated the different impact of both programs, and validated our analysis using quantile regression techniques.

Results

We found evidence of better mean glycemic control in patients receiving the patient-centered program, which engaged better patients. Nevertheless, that differential impact is nonmonotonic. Patients initially at the healthy range at the patient-centered program maintained their condition better. Patients close to, but not within, the healthy range benefited equally from attending either program. Patients with very high glycemic level benefited significantly more from attending the patient-centered program. Finally, patients with the worst initial glycemic control (far from the healthy range) improved equally their diabetic condition, regardless of which program they attended.

Item Type: Article
Additional Information: Acknowledgements and sources of financial support: This research was conducted through the project “The Contribution of Public and Private Services to European Growth and Welfare, and the Role of Public-Private Innovation Networks (ServPPIN)”, financed by the European Commission, VII Framework Programme (FP7-SSH-2007-1); and through the project “La innovación en servicios y las interacciones entre servicios públicos y privados: el caso de la sanidad”, financed by the Ministerio de Ciencia e Innovación in Spain. Manuel García-Goñi also thanks the Ramón Areces Foundation for financial support starting November 2014 under the research project “Envejecimiento y sistema sanitario y social. El gasto público y sus efectos en igualdad, dependencia y aseguramiento en España”. The authors thank Pedro Pita Barros, Ricardo Mora, members of the ServPPIN European network, and participants at the Spanish Health Economics Association Meeting for their helpful comments. Any errors are the authors’ responsibility. Conflicts of interest: There are no conflicts of interest for any of the authors.
Keywords: Chronic disease self-management; Patient-centered education; Quantile regression
Schools/Departments: University of Nottingham, UK > Faculty of Social Sciences > Nottingham University Business School
Identification Number: 10.1016/j.jval.2016.01.014
Depositing User: Howis, Jennifer
Date Deposited: 22 Feb 2017 10:57
Last Modified: 12 Oct 2017 22:20
URI: http://eprints.nottingham.ac.uk/id/eprint/40696

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