Department of Internal Medicine/Primary Care, Care Improvement Collaborative - Strategies to Advance Rational Therapy Clinic, Stroger Cook County Hospital, Chicago, Illinois, USA.
Diabetes Ther. 2011 Sep;2(3):178-88. doi: 10.1007/s13300-011-0007-y. Epub 2011 Aug 22.
This study evaluated the impact of a waiting room-administered, low-literacy, computer multimedia diabetes education program on patient self-management and provider intensification of therapy.
In this randomized, controlled trial, 129 participants either viewed a computer multimedia education program (intervention group) or read an educational brochure (control group) while in the waiting room. Participants were uninsured, primarily ethnic minority adults with type 2 diabetes receiving care from a county clinic in Chicago, Illinois. Wilcoxon test, t-test, and linear mixed model analyses evaluated changes in diabetes knowledge, self-efficacy, behaviors, medications prescribed, hemoglobin A1c (HbA(1c)), and blood pressure levels over 3 months.
During the study period, there was an increase in the number of oral diabetes medications prescribed over three months to multimedia users compared with those in the control group (P=0.017). HbA(1c) declined by 1.5 in the multimedia group versus 0.8 in the control group (P=0.06). There were no differences between groups in changes in blood pressure levels, self-efficacy, and most diabetes-related behaviors. Self-reported exercise increased in the control group compared with the multimedia group (0.9 days/week vs. 0.1 days/week, P=0.016).
Multimedia users received a greater intensification of diabetes therapy, but demonstrated no difference in self-management in comparison with those receiving educational brochures. The availability of a computer multimedia program in the waiting room appears to be a novel and acceptable approach in providing diabetes education for underserved populations.
本研究评估了在候诊室提供的低识字率计算机多媒体糖尿病教育计划对患者自我管理和提供者强化治疗的影响。
在这项随机对照试验中,129 名参与者在候诊室中观看计算机多媒体教育计划(干预组)或阅读教育手册(对照组)。参与者没有保险,主要是少数民族成年人,患有 2 型糖尿病,在伊利诺伊州芝加哥的一家县诊所接受治疗。使用 Wilcoxon 检验、t 检验和线性混合模型分析评估了 3 个月内糖尿病知识、自我效能、行为、开处方的药物、糖化血红蛋白(HbA1c)和血压水平的变化。
在研究期间,与对照组相比,多媒体使用者在三个月内口服糖尿病药物的数量增加(P=0.017)。多媒体组的 HbA1c 下降了 1.5,而对照组下降了 0.8(P=0.06)。两组间血压水平、自我效能和大多数糖尿病相关行为的变化无差异。与多媒体组相比,对照组的自我报告运动增加(每周 0.9 天/周与每周 0.1 天/周,P=0.016)。
多媒体使用者接受了更强化的糖尿病治疗,但与接受教育手册的患者相比,自我管理方面没有差异。在候诊室提供计算机多媒体程序似乎是为服务不足人群提供糖尿病教育的一种新颖且可接受的方法。