Telephone coaching aids diabetes control in rural communities
MedWire News: Telephone coaching is an effective, low-cost method for improving self-management of diabetes among rural residents, say US researchers.
The findings come from an 8-week telephone-coaching intervention carried out as part of the On the Road to Living Well with Diabetes (OTR) education program.
During the intervention, student pharmacists made weekly telephone phone calls to 50 individuals who had completed the OTR 6-week program in three rural Washington counties, report Linda Maclean and team from Washington State University College of Pharmacy in Pullman.
The coaches used motivational interviewing techniques to support lifestyle modifications for successful management of diabetes, including implementing appropriate self-care strategies, monitoring blood glucose, adhering to medications, following diet and exercise regimens, and getting regular medical care.
Glycated hemoglobin (HbA1c) and blood pressure levels were measured at enrollment and at follow-up 3 months after OTR, and the participants completed a standardized questionnaire to provide information about their diabetes management before and after the study.
The researchers compared the clinical data and questionnaire results with those from individuals who had participated in the OTR program the previous year and who had not taken part in a telephone-coaching intervention.
As reported in Clinical Diabetes, among patients who had a baseline HbA1c of less than 7% the mean change in HbA1c was not significantly different between the groups, at -0.15% in the control group and -0.09% for the coaching group 3 months after OTR. Among those with an HbA1c of 7% or more, there was a significant difference in the change in HbA1c, at -0.5% for the control group and -1.3% in the coaching group.
Systolic and diastolic blood pressure were not significantly different between the groups either before or after the coaching program.
The questionnaire results revealed a broad agreement among participants (79.2%) that their coach helped them figure out how to better control diabetes, that their coach's encouragement was important in controlling diabetes (72.9%), that coaching was an important part of the overall program (83.4%), and that coaching enhanced the OTR classes (68.8%).
The team says that the demonstrated positive impacts of telephone coaching on participants' attitude and behavior may represent a pathway to clinical impact that requires time beyond the end of coaching to manifest.
"Further investigation is needed to determine what this clinical impact might be, including expanded timelines for post-testing, coaching by students in other healthcare disciplines, and specific testing of coaching elements that support high-impact patient self-care such as medication-taking and attention to diet," conclude Maclean and team.
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