Kirsty Winkley1, Daniel Stahl2, Mark Chamley3, Rosanna Stopford4, Monica Boughdady5, Stephen Thomas6, Stephanie A Amiel5, Angus Forbes7, Khalida Ismail4. 1. Dept of Psychological Medicine, King's College London & Institute of Psychiatry, Psychology & Neuroscience, London, UK. Electronic address: kirsty.winkley@nhs.net. 2. Dept of Biostatistics, King's College London & Institute of Psychiatry, Psychology & Neuroscience, London, UK. 3. Lambeth Diabetes Clinical Lead, Crown Dale Medical Centre, Lambeth, London, UK. 4. Dept of Psychological Medicine, King's College London & Institute of Psychiatry, Psychology & Neuroscience, London, UK. 5. Dept of Diabetes & Nutrition, King's College London & School of Medicine, London, UK. 6. Dept of Diabetes & Endocrinology, Guy's & St Thomas' NHS Foundation Trust, London, UK. 7. Dept of Primary and Intermediate Care, King's College London & Nightingale School of Nursing & Midwifery, London, UK.
Abstract
OBJECTIVE: The aims were to determine the association between individual and neighbourhood factors and attendance at structured education amongst people with newly diagnosed type 2 diabetes (T2DM). METHODS: Multi-level analysis of questionnaire data from a prospective cohort of adults newly diagnosed T2DM. Setting was primary care, London, UK. Main outcome was attendance at structured education within 2 years. RESULTS: Of 1790 people recruited, attendance data were available for 1626 (91%). Only 22.4% (n=365/1626) attended education. Attendance was independently associated with female gender (OR 1.28, 95% CI 1.05-1.46), lower HbA1c (OR 0.98 mmol/mol 95% CI 0.97-0.99) and non-smoker status (OR 1.36, 95% CI 1.07-1.55). General practice covariates, achievement of primary care targets for glycaemic control (OR 1.05, 95% C.I. 1.01-1.08) and recording of retinal screening (OR 0.96, 95% C.I. 0.93-0.99) were independently associated with attendance but unexplained general practice clustering accounted for 17% of the variance. CONCLUSION: Education uptake is low amongst people with new onset T2DM. Attenders are more likely to be female, non-smokers with better HbA1c. General practices achieving glycaemic targets are more likely to have patients who attend education. PRACTICE IMPLICATIONS: Strategies are needed to improve attendance at structured diabetes education particularly amongst hard to reach groups.
OBJECTIVE: The aims were to determine the association between individual and neighbourhood factors and attendance at structured education amongst people with newly diagnosed type 2 diabetes (T2DM). METHODS: Multi-level analysis of questionnaire data from a prospective cohort of adults newly diagnosed T2DM. Setting was primary care, London, UK. Main outcome was attendance at structured education within 2 years. RESULTS: Of 1790 people recruited, attendance data were available for 1626 (91%). Only 22.4% (n=365/1626) attended education. Attendance was independently associated with female gender (OR 1.28, 95% CI 1.05-1.46), lower HbA1c (OR 0.98 mmol/mol 95% CI 0.97-0.99) and non-smoker status (OR 1.36, 95% CI 1.07-1.55). General practice covariates, achievement of primary care targets for glycaemic control (OR 1.05, 95% C.I. 1.01-1.08) and recording of retinal screening (OR 0.96, 95% C.I. 0.93-0.99) were independently associated with attendance but unexplained general practice clustering accounted for 17% of the variance. CONCLUSION: Education uptake is low amongst people with new onset T2DM. Attenders are more likely to be female, non-smokers with better HbA1c. General practices achieving glycaemic targets are more likely to have patients who attend education. PRACTICE IMPLICATIONS: Strategies are needed to improve attendance at structured diabetes education particularly amongst hard to reach groups.
Authors: Yilin Yoshida; Dongzhe Hong; Elizabeth Nauman; Eboni G Price-Haywood; Alessandra N Bazzano; Charles Stoecker; Gang Hu; Yun Shen; Peter T Katzmarzyk; Vivian A Fonseca; Lizheng Shi Journal: BMJ Open Diabetes Res Care Date: 2021-12
Authors: Jamie Ross; Fiona Stevenson; Charlotte Dack; Kingshuk Pal; Carl May; Susan Michie; Maria Barnard; Elizabeth Murray Journal: BMC Health Serv Res Date: 2018-10-19 Impact factor: 2.655