Low attendance at structured education for people with newly diagnosed type 2 diabetes: General practice characteristics and individual patient factors predict uptake

Patient Educ Couns. 2016 Jan;99(1):101-7. doi: 10.1016/j.pec.2015.08.015. Epub 2015 Aug 13.

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.

Keywords: Attendance; Education; General practice; Primary health care; Type 2 diabetes mellitus; Uptake.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / psychology
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • General Practice*
  • Health Services Accessibility
  • Humans
  • London
  • Male
  • Middle Aged
  • Motivation
  • Multilevel Analysis
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Compliance / psychology*
  • Patient Compliance / statistics & numerical data
  • Patient Education as Topic / statistics & numerical data*
  • Primary Health Care
  • Prospective Studies
  • Self Care
  • Sex Distribution
  • Surveys and Questionnaires