Applying the Stages of Change model to Type 2 diabetes care in Trinidad: A randomised trial.

Show simple item record Partapsingh, V A Maharaj, R G Rawlins, J M 2012-03-30T05:32:29Z 2012-03-30T05:32:29Z 2011-10-11
dc.identifier.citation Journal of Negative Results in BioMedicine. 2011 Oct 11;10(1):13
dc.description.abstract Abstract Objective To improve glycaemic control among Type 2 diabetics using patient-physician consultations guided by the Stages of Change (SOC) model. Design and Methods A randomised trial was conducted. After ensuring concealment of allocation, Type 2 diabetics were randomly assigned to receive the intervention or the control. The intervention consisted of identifying each patient's Stage of Change for managing their diabetes by diet, exercise and medications, and applying personalised, stage-specific care during the patient-physician consultations based on the SOC model. Patients in the control group received routine care. The variables of interest were effect on glycaemic control (measured by the difference in HbA1c levels) and patients' readiness to change (measured by identifying patients' SOC for managing their diabetes by diet, exercise and medications). Results Participants were primarily over age 50, male and Indo-Trinidadian. Most had received only a primary school education and over 65% had a monthly income of $320 USD/month or less. Sixty-one Type 2 diabetics participated in each arm. Three patients were lost to follow-up in the intervention arm. After 48 weeks, there was an overall increase in HbA1c of 0.52% (SE 0.17) and 1.09% (SE 0.18) for both the intervention and control groups respectively. There was a relative reduction in HbA1c of 0.57% (95% CI 0.07, 1.07) with the intervention group compared to the control (p = 0.025). For exercise and diet there was an overall tendency for participants in the intervention arm to move to a more favourable SOC, but little change was noted with regards medication use. Conclusions The result suggests a tendency to a worsening of glycaemic control in this population despite adopting more favourable SOC for diet and exercise. We hypothesized that harsh social conditions prevailing at the time of the study overrode the clinical intervention.
dc.title Applying the Stages of Change model to Type 2 diabetes care in Trinidad: A randomised trial.
dc.type Journal Article 2012-03-30T05:32:30Z
dc.description.version Peer Reviewed
dc.language.rfc3066 en
dc.rights.holder Partapsingh et al.; licensee BioMed Central Ltd.

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