Diabetes Mellitus, Hyperglycemia
Conditions
Keywords
Diabetes mellitus, Hyperglycemia, Inpatient, self-management education
Brief summary
A learner-centered diabetes survival skills self-management education program was provided to adults with uncontrolled diabetes in the hospital and generated preliminary evidence of impact on medication adherence and a trend toward reduction in hospital and emergency department admissions.
Detailed description
This study was a prospective, nonrandomized pilot study conducted among adults with uncontrolled diabetes admitted to the Medicine Service of an urban tertiary teaching hospital were consented to participate in a pilot study which provided diabetes survival skills education. Based on knowledge deficits identified on a diabetes knowledge pre-test the patient was directed to view video content corresponding to those deficiencies and content on sick days and diabetes complications. Evaluation measures were diabetes knowledge, medication adherence, and hospital admissions plus emergency department visits at and/or 3months before baseline and at 2 weeks and 3 months post-discharge. There was improvement in diabetes knowledge and medication adherence, which was sustained to 3 months. A trend was observed toward reduction in emergency department and/or hospital admissions from 3 months pre-intervention to 3 months post-discharge for uncontrolled diabetes. This knowledge-based program successfully provided survival skills education to hospital patients with uncontrolled diabetes and demonstrated preliminary evidence of a positive impact on medication adherence and a trend toward reduction in hospital and emergency department admissions.
Interventions
BEHAVIORALdiabetes self-management education
1-group, pre-test/post-test design feasibility and preliminary efficacy evaluation of diabetes survival skills self-management education delivered at the hospital bedside.
Sponsors
Sanofi
Medstar Health Research Institute
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* English speaking with a diabetes mellitus diagnosis (ICD 9 codes 250.xx) * an admitting blood glucose level of \> 200 mg/dL or ≤ 40 mg/dL, and * an anticipated hospital stay of ≥ 2 days, as estimated by the medical staff, to allow sufficient time for delivery of program content
Exclusion criteria
* pregnancy * admission to an intensive care unit, and * any medical condition or cognitive dysfunction that, in the opinion of the investigator, would preclude active participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of change in Diabetes knowledge as measured by an 11-item diabetes knowledge survey | Baseline score obtained before receiving the education intervention. Post test score obtained immediately after the education intervention was completed during the hospital stay, usually within 24 hours or less from the baseline score | 11-item diabetes knowledge survey administered pre- and post- education intervention during the same hospital stay. Baseline score and post intervention score obtained within a 24 hour period |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Readmissions to the hospital and the emergency department | 3 months pre- and 3 months post-intervention | Self-reported historic and post-intervention visits to ED and or admissions to the hospital |
| Medication adherence (Modified Morisky Medication Adherence Scale 4-item) | Baseline pre intervention then at 2 weeks after intervention and at 3 months post-intervention | Modified Morisky Medication Adherence Scale 4-item |
Outcome results
None listed