Effectiveness of group-based self-management education for individuals with Type 2 diabetes: A systematic review with meta-analyses and meta-regression

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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 HbA1c and followed participants for ≥ 6 months were included. The primary outcome was HbA1c , and secondary outcomes included fasting blood glucose, weight, BMI, 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. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)1027-1039
Number of pages13
JournalDiabetic Medicine
Volume34
Issue number8
Early online date22 Feb 2017
DOIs
Publication statusPublished - Aug 2017

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Self Care
Meta-Analysis
Type 2 Diabetes Mellitus
Education
Confidence Intervals
Waist Circumference
Blood Glucose
Life Style
Fasting
Waiting Lists
Self Efficacy
Patient Education
Publications
Triglycerides
Body Weight
Databases
Blood Pressure
Lipids
Weights and Measures
Health

Cite this

@article{00f4ad25124044989efd4fad759a8a68,
title = "Effectiveness of group-based self-management education for individuals with Type 2 diabetes: A systematic review with meta-analyses and meta-regression",
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 HbA1c and followed participants for ≥ 6 months were included. The primary outcome was HbA1c , and secondary outcomes included fasting blood glucose, weight, BMI, 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. This article is protected by copyright. All rights reserved.",
author = "K Odgers-Jewell and Ball, {L E} and Kelly, {J T} and Isenring, {E A} and Reidlinger, {D P} and R Thomas",
note = "This article is protected by copyright. All rights reserved.",
year = "2017",
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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. / Odgers-Jewell, K; Ball, L E; Kelly, J T; Isenring, E A; Reidlinger, D P; Thomas, R.

In: Diabetic Medicine, Vol. 34, No. 8, 08.2017, p. 1027-1039.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Effectiveness of group-based self-management education for individuals with Type 2 diabetes

T2 - 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

N1 - This article is protected by copyright. All rights reserved.

PY - 2017/8

Y1 - 2017/8

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 HbA1c and followed participants for ≥ 6 months were included. The primary outcome was HbA1c , and secondary outcomes included fasting blood glucose, weight, BMI, 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. This article is protected by copyright. All rights reserved.

AB - 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 HbA1c and followed participants for ≥ 6 months were included. The primary outcome was HbA1c , and secondary outcomes included fasting blood glucose, weight, BMI, 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. This article is protected by copyright. All rights reserved.

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U2 - 10.1111/dme.13340

DO - 10.1111/dme.13340

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JO - Diabetic Medicine

JF - Diabetic Medicine

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