Patient factors associated with attrition from a self-management education programme.
OBJECTIVE
To examine utilization patterns of diabetes self-management training (DSME) and identify patient factors associated with attrition from these services at an ambulatory diabetes education centre (DEC).


METHODS
A retrospective medical chart review of first time visits (536) to the centre between 1 August 2000 and 31 July 2001 was conducted for patients with type 2 diabetes. Descriptive analyses were conducted to examine utilization patterns over a 1-year period. Multivariable logistic regression was used to identify patient factors associated with attrition from DSME and non-use of group education among new patients.


RESULTS
Almost 50% of new patients withdrew prematurely from recommended DSME services over the 1-year period, and only 24.8% attended group education. Patient variables such as being older than 65 years of age, primarily speaking English, or working full or part-time were associated with attrition from DSME and non-use of group education when compared with middle aged, non-English-speaking, and non-working patients.


CONCLUSIONS
High DSME attrition rates indicate that retention needs to become a focus of programme policy, planning and evaluation to improve programme effectiveness. DSME tailored to the cultural and linguistic characteristics of the community, and convenient and accessible to working and older patients will potentially increase retention in and accessibility to these services.
Gucciardi
Enza
E
Ryerson University, School of Nutrition, Toronto, Ontario, Canada. enza.gucciardi@uhnres.utoronto.ca
DeMelo
Margaret
M
Offenheim
Ana
A
Grace
Sherry L
SL
Stewart
Donna E
DE
D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001294:Attitude to Health; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control* / Q000628:therapy; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts / Q000145:classification*; D010353:Patient Education as Topic; D010358:Patient Participation; D012189:Retrospective Studies; D012648:Self Care; D014478:Unemployment