Structured diabetes education program for improving self-care behavior in primary care settings of Puducherry: Evidence from a randomized controlled trial

• Main Authors: Mamta Gehlawat, Subitha Lakshminarayanan, Sitanshu Sekhar Kar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Indian Journal of Community Medicine
• Subjects: Diabetes mellitus; randomized controlled trial; self-care
• Online Access: http://www.ijcm.org.in/article.asp?issn=0970-0218;year=2019;volume=44;issue=2;spage=107;epage=112;aulast=Gehlawat
• ISSN: 0970-0218; 1998-3581

Context: Diabetes self-management education plays a critical role in improving patients' clinical outcome and quality of life. Aims: This study aims to study the effectiveness of a structured diabetes educational program on improvement of self-care behavior among type 2 diabetics in urban Primary Health Centres (PHCs) of Puducherry. Settings and Design: A community-based open-label parallel-arm randomized controlled trial was conducted in two randomly selected urban PHCs of Puducherry during December 2015–February 2017. Subjects and Methods: Using systematic random sampling, 157 eligible participants were recruited in intervention and control PHCs each. Sociodemographic, disease characteristics, and anthropometric measures were captured using a pretested questionnaire at baseline. Self-care behavior was recorded with Summary of Diabetes Self-Care Activities scale. Intervention consisted of structured diabetes education sessions with distribution of information leaflets and self-care kits to the intervention-arm participants, while control arm received standard care. At the end of 6 months, endline assessment was done for both groups. Data were analyzed by intention-to-treat, per-protocol, and difference-in-difference analysis using STATA. Results: Footcare increased significantly by 1.95 days/week compared to control arm, while a moderate change of 0.49 days/week in diet compliance and a minimal change of 0.10 days/week in physical activity were observed. Medication adherence, regular blood sugar testing, and smoking behavior also showed improvement in intervention arm. Conclusions: A structured education program that is culturally tailored showed an overall improvement in self-care behavior. This research supports the need for structured education program for diabetics to empower them and improve self-care practices. Trial registration: CTRI/2017/06/008772