A pilot randomized trial in primary care to investigate and improve knowledge, awareness and self-management among South Asians with diabetes in Manchester.
OBJECTIVE
To investigate whether a secondary-primary care partnership education package could improve understanding of diabetes care among South Asians.


METHODS
In a pilot randomized controlled trial, in the setting of eight general practices randomized to intervention or control, patients were invited to four or more rotating visits per year by one of a diabetes specialist nurse, dietician or chiropodist working with general practice staff. Participants were from lists of South Asian patients with known Type 2 diabetes in each (general) practice.


RESULTS
Patients and practice scores at baseline and 1-year follow-up, from an interview using a questionnaire on knowledge, awareness and self-management of diabetes. Responses were developed into educational packages used during intervention. Of the 411 patients listed at baseline only 211 were traced for interview (refusal only 4%). Mean age was 55.4 years, age of diabetes onset 47.1 years. Fourteen percent were employed and 35% were able to communicate in English fluently. Only 118 could be traced and interviewed at 1 year, although there was no significant difference in demography between those who completed the study and those who did not. Despite a mean of four visits/patient, intervention had no impact on scores for diabetes knowledge, or awareness [score change 0.14, 95% confidence interval (CI) -0.20, 0.49] or self-management (-0.05, 95% CI -0.48, 0.39) between baseline and 1 year.


CONCLUSIONS
This form of secondary/primary care support did not transfer information effectively, and we suspect similar problems would arise in other similar communities. Different methods of clinician/patient information exchange need to be developed for diabetes in this South Asian group.
Vyas
A
A
Clinical Epidemiology & Biostatistics Group, University of Manchester Medical School and Manchester Diabetes Centre/Royal Infirmary, UK. avni.vyas@man.ac.uk
Haidery
A Z
AZ
Wiles
P G
PG
Gill
S
S
Roberts
C
C
Cruickshank
J K
JK
D000328:Adult; D001208:Asia / Q000208:ethnology; D001364:Awareness; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000523:psychology*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011320:Primary Health Care / Q000379:methods*; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires