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Cited by 102Diabetes Management and EducationHealth Policy Implementation ScienceDiabetes Management and Research

Patient education—evaluation of a complex intervention

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I., Mühlhauser, M., Berger·2002·Diabetologia
DOI 10.1007/s00125-002-0987-2
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Abstract

Diabetes education or self-management programmes are complex interventions. Their evaluation is difficult because of problems in identifying and separately assessing the effect of the various components of the intervention. A phased approach defining sequential stages of a continuum of increasing evidence has been proposed as a framework for the design and evaluation of such complex interventions. As an example we present the available evidence for diabetes treatment and teaching programmes implemented in Germany. Evidence is compiled for structured group treatment and teaching programmes for Type I diabetes, non-insulin dependent Type II diabetes, and hypertension according to the following sequential stages of increasing evidence: (i) preclinical or theoretical phase; (ii) modelling the components of the intervention; (iii) exploratory trials; (iv) randomized controlled trials; (v) phase of implementation including replication and transfer to different settings. Evidence for most of these phases has been generated for the three programmes, although individual studies do not fulfill all important quality criteria by today's standards. The time span for gathering the evidence from the theoretical phase to surveillance after implementation was about 20 years. It can only be speculated which parts of the programmes are the most active ones. The presentation of a continuum of increasing evidence for diabetes education or self-management programmes could provide useful information for the appraisal of such complex interventions. Since this evidence cannot be readily extracted from databases we suggest that other research groups present their data in a similar way.

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  • There is convincing evidence that formal training programs that teach patients to replace insulin "physiologically" by giving background and mealtime/correction doses of insulin can reduce the risk of severe hypoglycemia.

    “There is convincing evidence that formal training programs that teach patients to replace insulin “physiologically” by giving background and mealtime/correction doses of insulin can reduce the risk of severe hypoglycemia.”

    From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [100]

  • Formal training programs that teach patients to replace insulin 'physiologically' by giving background and mealtime/correction doses of insulin can reduce the risk of severe hypoglycemia.

    “There is convincing evidence that formal training programs that teach patients to replace insulin ' physiologically ' by giving background and mealtime/ correction doses of insulin can reduce the risk of severe hypoglycemia.”

    From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [100]

  • The Insulin Treatment and Training programs developed by Mühlhauser and Berger have reported improved glycemic control comparable with DCCT while reducing the rates of severe hypoglycemia.

    “The Insulin Treatment and Training programs developed by M € uhlhauser and Berger (100) have reported improved glycemic control comparable with DCCT while reducing the rates of severe hypoglycemia (101,102).”

    From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [100]

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Research works printed but not linked: 3

  1. [3]3. Norris SL, Engelgau MM, Narayan KMV (2001) Effective- ness of self-management training in Type 2 diabetes. A systematic review of randomized controlled trials. Diabetes Care 24:561-587
  2. [5]5. Renders CM, Valk GD, Griffin S, Wagner EH, Eijk van JT, Assendelft WJJ (2001) Interventions to improve the man- agement of diabetes mellitus in primary care, outpatient, and community settings (Cochrane Review). In: The Cochrane Library, Issue 4, 2001. Oxford: Update Software (also: Diabetes Care 2001; 24:1812-1833)
  3. [15]15. Berger M, Jörgens V (2001) Praxis der Insulintherapie 6th edn. Springer, Berlin Heidelberg New York

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Authors
I., M., & M., B.
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
2002-12-01
Volume
45
Issue
12
Pages
1723-1733
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/s00125-002-0987-2
OpenAlex
W2000503313
Cited by
102
References
36
Citations by year
2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 1 · 2016: 8 · 2015: 6 · 2014: 3 · 2013: 5 · 2012: 3
FWCI
2.66
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
diabetes education, self-management program, complex interventions, intervention evaluation, type 1 diabetes, type 2 diabetes, hypertension, randomized controlled trials, exploratory trials, implementation
MeSH terms
Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Germany, Humans, Hypertension, Patient Education as Topic, Self Care, Teaching, Randomized Controlled Trials as Topic

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