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Effectiveness of group-based self-management education for individuals with Type 2 diabetes: a systematic review with meta-analyses and meta-regression.
Diabet Med 2017; 34(8):1027-1039DM

Abstract

AIMS

Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self-management behaviours. This systematic review aimed to determine the effectiveness of group-based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.

METHODS

Six electronic databases were searched. Group-based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c , and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self-efficacy.

RESULTS

Fifty-three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group-based education compared with controls at 6-10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): -0.48, -0.15; P = 0.0002], 12-14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: -0.49, -0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: -1.26, -0.18; P = 0.009] and 36-48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: -1.52, -0.34; P = 0.002], but not at 24 months. Outcomes also favoured group-based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer-led interventions.

CONCLUSIONS

Group-based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.

Authors+Show Affiliations

Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.Centre for Research in Evidence-Based Practice (CREBP), Bond University, Gold Coast, Australia.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

28226200

Citation

Odgers-Jewell, K, et al. "Effectiveness of Group-based Self-management Education for Individuals With Type 2 Diabetes: a Systematic Review With Meta-analyses and Meta-regression." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 34, no. 8, 2017, pp. 1027-1039.
Odgers-Jewell K, Ball LE, Kelly JT, et al. Effectiveness of group-based self-management education for individuals with Type 2 diabetes: a systematic review with meta-analyses and meta-regression. Diabet Med. 2017;34(8):1027-1039.
Odgers-Jewell, K., Ball, L. E., Kelly, J. T., Isenring, E. A., Reidlinger, D. P., & Thomas, R. (2017). Effectiveness of group-based self-management education for individuals with Type 2 diabetes: a systematic review with meta-analyses and meta-regression. Diabetic Medicine : a Journal of the British Diabetic Association, 34(8), pp. 1027-1039. doi:10.1111/dme.13340.
Odgers-Jewell K, et al. Effectiveness of Group-based Self-management Education for Individuals With Type 2 Diabetes: a Systematic Review With Meta-analyses and Meta-regression. Diabet Med. 2017;34(8):1027-1039. PubMed PMID: 28226200.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of group-based self-management education for individuals with Type 2 diabetes: a systematic review with meta-analyses and meta-regression. AU - Odgers-Jewell,K, AU - Ball,L E, AU - Kelly,J T, AU - Isenring,E A, AU - Reidlinger,D P, AU - Thomas,R, Y1 - 2017/03/20/ PY - 2017/02/17/accepted PY - 2017/2/23/pubmed PY - 2018/5/3/medline PY - 2017/2/23/entrez SP - 1027 EP - 1039 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 34 IS - 8 N2 - AIMS: Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self-management behaviours. This systematic review aimed to determine the effectiveness of group-based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes. METHODS: Six electronic databases were searched. Group-based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c , and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self-efficacy. RESULTS: Fifty-three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group-based education compared with controls at 6-10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): -0.48, -0.15; P = 0.0002], 12-14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: -0.49, -0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: -1.26, -0.18; P = 0.009] and 36-48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: -1.52, -0.34; P = 0.002], but not at 24 months. Outcomes also favoured group-based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer-led interventions. CONCLUSIONS: Group-based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/28226200/Effectiveness_of_group_based_self_management_education_for_individuals_with_Type_2_diabetes:_a_systematic_review_with_meta_analyses_and_meta_regression_ L2 - https://doi.org/10.1111/dme.13340 DB - PRIME DP - Unbound Medicine ER -