Can a brief illness perception intervention improve adherence and glycemic control in patients with type 2 diabetes?

Patients with poorly controlled type 2 diabetes and nominated family members will be randomised to receive either the intervention described below plus standard care (intervention group), or standard care plus standard diabetes pamphlets (control group). The intervention consists of three main components: (1) discussion about illness perceptions and beliefs about diabetes medication including patient education, (2) an animated video describing type 2 diabetes and treatment, and (3) a personalized action plan and discussion of barriers to behaviour change. The starting point for the intervention is a discussion about illness perceptions and beliefs about medication of type 2 diabetes held by the patient and the family member assessed before the intervention. During this discussion, illness perception dimensions and beliefs regarding the necessity of diabetes medication and concerns about side effects and how they can affect self-care behaviours will be explored. Maladaptive perceptions and beliefs will be challenged by providing medical explanations regarding type 2 diabetes and its treatment. Patients and their family members will then be asked to watch a brief animated video of type 2 diabetes on an iPad provided by the researcher. The animated video is being developed in consultation with endocrinologists in New Zealand and Saudi Arabia. The video will show the inside of the body, how glucose and insulin interact, what goes wrong when you have type 2 diabetes, and how the treatment can control blood glucose levels. Finally, a written personalised action plan to improve patient’s adherence to Metformin, healthy eating, and exercise will be developed in collaboration with the patient and their family member. Barriers to adaption of the behaviours will be discussed and taken into account. The intervention group will also be given written information about type 2 diabetes and self-care to take home. The intervention will be structured (e.g. participants watch the same animated video of type 2 diabetes) but also individually tailored to each patient (discussion about illness perceptions and developing a personalised action plan). This brief intervention will consist of one face-to-face session (90 minutes) with patients with type 2 diabetes and their nominated family members and a follow up phone call (10-15 minute) one week later with the patient only. The intervention will be delivered by the primary researcher.