Patient education: impact on care outcomes, resources consumption and absenteeism. International Diabetes Management Practices Study (IDMPS) data.

GAGLIARDINO JJ; ASCHNER P; BAIK S-H; CHAN J; ILKOVA H; RAMACHANDRAN A

Estocolmo

Congreso; 46th EASD Annual Meeting; 2010

EASD

Background: Achievement of diabetes treatment goals greatly depends on the patient¢¥s active and efficient participation in the control and treatment of the disease. Even when evidence has demonstrated the value of education to obtain such participation, in many places education is considered an additional cost rather than an important component of diabetes care. Aim: To measure diabetes care indicators and resources consumption in a population of educated and non educated persons with type 2 diabetes. Material and Methods: The IDMPS is an international, multicenter, observational study performed in 27 countries within Africa, Asia, Eastern Europe, Middle East and Latin America. Data were collected from people with type 1 and 2 diabetes (¡Ã18 years) seen in current medical practice in yearly cycles (2-week cross-sectional recruitment period followed by a 9-month longitudinal period for type 2 patients) for 5 years. IDMPS was performed in compliance with the Helsinki Declaration and Good Clinical Practice Standards. We currently report and compare results from 11384 people with type 2 diabetes (educated vs. non educated, 5692 in each group, paired by age, gender and diabetes duration) recruited during the second cross-sectional period (November and December 2006). Data were analyzed using the Wilcoxon and the chi2 tests for continuous and categorical variables, respectively. Results: The mean age ¡¾ SD for both groups was 57.7 ¡¾ 11.1 (53.1% female), with an average BMI of 28 ¡¾ 5.2 and 8 ¡¾ 7 years of diabetes duration. Educated patients had significantly (p< 0.001) higher figures of people with normal BMI (28.3 vs. 24.4%), diastolic BP <80 mm Hg (36.5 vs. 32.3%), HbA1c < 7.0% (38.1 vs. 35.8%), LDL-c < 100 mg/dL (39.5 vs. 33%) and triglyceride < 150 mg/dL (52.7 vs. 49%). The percentage of complications was low in both groups (<20%), but the educated group had significantly lower values of people with proteinuria (16.6 vs. 18%) and foot ulcer (2.4 vs. 3.5%). Visits of educated patients to specialists increased by 21%, as well as insulin treatment (40%), fasting (10%) and postprandial (52%) SMBG performance. Absenteeism was 15% lower in educated patients. Conclusions: These data, one of the largest reported on education of people with type 2 diabetes, demonstrate that education can significantly improve treatment outcomes, with a low increase in resources consumption and a decrease in absenteeism. They also show that education is an efficient tool to improve diabetes care quality with low impact on resources consumption and additional positive impact on productivity, particularly important for developing countries that bear the heaviest part of the global diabetes epidemic.  Supported by an unrestricted grant from sanofi-aventis.