[Pilot study of two different strategies to reinforce self care behaviors and treatment compliance among type 2 diabetes patients from low income strata]

Abstract

Long term diabetes self-management behaviors, and strict glycemic control are difficult to achieve in clinical practice.

Objective: Asesss two different reinforcement strategies for diabetes selfcare management, psychological distress and glycemic control in a one year follow up study.

Methods: 70 consecutive type 2 diabetic patients, were recruited and randomly assigned to three study groups. Subjects in the control group (CG) continued with their normal treatment schedule. The second group received a reinforcement course at 6 months (RCG) and in the third group, patients were contacted monthly by phone (PHCG) to promote self-management attitudes and address problems as they arose. A battery of questions and laboratory work-up were obtained at baseline and at one year follow-up.

Results: At one year follow-up, the three groups significantly increased their diabetes-related knowledge. Both experimental groups displayed improved treatment compliance and had better adherence to the recommended meal plan (p=0.06 and 0.003). In addition, the PHCG significantly increased (p<0.0001) their adherence to pharmacological treatment. No significant differences were observed in glycemic control, prevalence of depression or diabetes related distress.

Conclusions: Follow-up patient reinforcement strategies improve strategic diabetes self-care management behaviors. Further studies are needed to demonstrate the positive impact of these benefits on diabetes related outcomes.