Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/1601
Título : Effectiveness of two interventions based on improving patient-practitioner communication on diabetes self-management in patients with low educational level: study protocol of a clustered randomized trial in primary care.
Autor : Ricci-Cabello, Ignacio
Olry de Labry-Lima, Antonio
Bolívar-Muñoz, Julia
Pastor-Moreno, Guadalupe
Bermudez-Tamayo, Clara
Ruiz-Pérez, Isabel
Quesada-Jiménez, Fermín
Moratalla-López, Enrique
Domínguez-Martín, Susana
de Los Ríos-Álvarez, Ana M
Cruz-Vela, Pilar
Prados-Quel, Miguel A
López-De Hierro, José A
Filiación: [Ricci-Cabello,I] Department of Primary Care Health Sciences, Health Services and Policy Research Group, NIHR School for Primary Care Research, University of Oxford, Oxford, England. [Olry de Labry–Lima,A; Bolívar-Muñoz,J; Pastor-Moreno,G; Bermudez-Tamayo,C; Ruiz-Pérez,I] Escuela Andaluza de Salud Pública, Granada, Spain.[Ricci-Cabello,I; Olry de Labry–Lima,O; Bolívar-Muñoz,J; Bermudez-Tamayo,C; Ruiz-Pérez] CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. [Bermudez-Tamayo,C] Hospital Universitario Virgen de las Nieves, Granada, Spain. [Quesada-Jiménez,F; Moratalla-López,E; Domínguez-Martín,S; Ríos-Álvarez,AM; Cruz-Vela,P; Prados-Quel,MA; López-De Hierro,JA] Centro de Salud Cartuja, Granada, Spain.
Palabras clave : Diabetes mellitus type 2
Primary care
Healthcare inequalities
Diabetes self-management
Quality of diabetes care
Diabetes Mellitus Tipo 2
Atención Primaria de Salud
Disparidades en Atención de Salud
MeSH: Medical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Diabetes Mellitus::Diabetes Mellitus, Type 2
Medical Subject Headings::Health Care::Health Services Administration::Patient Care Management::Comprehensive Health Care::Primary Health Care
Medical Subject Headings::Health Care::Health Services Administration::Patient Care Management::Delivery of Health Care::Healthcare Disparities
Fecha de publicación : 23-Oct-2013
Editorial : BioMed Central
Cita Bibliográfica: Ricci-Cabello I, Olry de Labry-Lima A, Bolívar-Muñoz J, Pastor-Moreno G, Bermudez-Tamayo C, Ruiz-Pérez I, et al. Effectiveness of two interventions based on improving patient-practitioner communication on diabetes self-management in patients with low educational level: study protocol of a clustered randomized trial in primary care. BMC Health Serv Res 2013; 13: 433
Abstract: BACKGROUND In the last decades the presence of social inequalities in diabetes care has been observed in multiple countries, including Spain. These inequalities have been at least partially attributed to differences in diabetes self-management behaviours. Communication problems during medical consultations occur more frequently to patients with a lower educational level. The purpose of this cluster randomized trial is to determine whether an intervention implemented in a General Surgery, based in improving patient-provider communication, results in a better diabetes self-management in patients with lower educational level. A secondary objective is to assess whether telephone reinforcement enhances the effect of such intervention. We report the design and implementation of this on-going study. METHODS/DESIGN The study is being conducted in a General Practice located in a deprived neighbourhood of Granada, Spain. Diabetic patients 18 years old or older with a low educational level and inadequate glycaemic control (HbA1c > 7%) were recruited. General Practitioners (GPs) were randomised to three groups: intervention A, intervention B and control group. GPs allocated to intervention groups A and B received training in communication skills and are providing graphic feedback about glycosylated haemoglobin levels. Patients whose GPs were allocated to group B are additionally receiving telephone reinforcement whereas patients from the control group are receiving usual care. The described interventions are being conducted during 7 consecutive medical visits which are scheduled every three months. The main outcome measure will be HbA1c; blood pressure, lipidemia, body mass index and waist circumference will be considered as secondary outcome measures. Statistical analysis to evaluate the effectiveness of the interventions will include multilevel regression analysis with three hierarchical levels: medical visit level, patient level and GP level. DISCUSSION The results of this study will provide new knowledge about possible strategies to promote a better diabetes self-management in a particularly vulnerable group. If effective, this low cost intervention will have the potential to be easily incorporated into routine clinical practice, contributing to decrease health inequalities in diabetic patients. TRIAL REGISTRATION Clinical Trials U.S. National Institutes of Health, NCT01849731.
Descripción : Journal Article;
URI: http://hdl.handle.net/10668/1601
Versión del editor : http://www.biomedcentral.com/1472-6963/13/433/abstract
DOI: 10.1186/1472-6963-13-433
ISSN : 1472-6963 (Online)
Appears in Collections:01- Artículos - DAP Granada
01- Artículos - Hospital Virgen de las Nieves
01- Artículos - EASP. Escuela Andaluza de Salud Pública

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