Change in metabolic control and functional status after hospitalization. Impact of patient activation intervention in diabetic patients.
OBJECTIVE
To determine whether a short intervention to enhance patient information seeking and decision making during hospitalization results in improved metabolic control and functional status in patients with diabetes mellitus.


METHODS
A randomized clinical trial was conducted in which control patients received a comprehensive 3-day evaluation and educational program, whereas experimental patients received a 45-min patient activation intervention and a 1-h self-administered booster in addition to the program. Metabolic control and functional status were measured at baseline and 4 mo postdischarge.


RESULTS
During their discharge discussions, experimental patients asked significantly more questions than control patients (7.4 vs. 3.0, P less than .001) and 4 mo later reported significantly fewer physical limitations in activities of daily living than the control group (P = 0.02). Improvement in metabolic control was statistically significant only for experimental patients (P = 0.02), although their glycosylated hemoglobin levels were not significantly lower than control patients' at follow-up. The intervention did not diminish physician satisfaction with patient interactions, although it may have increased physician frustration with responsibilities that competed with patient care.


CONCLUSIONS
These results suggest that the addition of a patient activation intervention to a comprehensive diabetes management program may substantially enhance physical functioning among adults with diabetes mellitus.
Rost
K M
KM
Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock 72205.
Flavin
K S
KS
Cole
K
K
McGill
J B
JB
D000203:Activities of Daily Living; D000328:Adult; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006760:Hospitalization; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D010358:Patient Participation; D012648:Self Care
D006442:Glycated Hemoglobin