title: Acceptability and effects of an educational leaflet on infections in type 2 diabetes patients: a randomized controlled trial in primary care.
abstract: OBJECTIVE
  To determine the acceptability of an educational leaflet regarding the prevention and treatment of infections of the lower respiratory tract (LRTIs) and urinary tract (UTIs) and to determine the effects of the leaflet on knowledge and attitude of DM2 patients in primary care.
  
  
  METHODS
  In a randomized controlled intervention trial 200 DM2 patients enlisted in two practices, one urban and one rural, from the Utrecht general practitioners Research Network (HNU) were selected. Per practice, 50 patients were randomly assigned to the intervention group and 50 to the control group. The intervention was a leaflet on diabetes and LRTIs and UTIs based on the results of focus group interviews. The leaflet was sent to the patients homes. The outcome measures were acceptability of the leaflet and differences in knowledge and attitude, measured by a questionnaire.
  
  
  RESULTS
  The mean age was 68 years and 55% was male. There were no substantial differences in characteristics between the two groups. Among the intervention group, the leaflet was appreciated as understandable (100%) and inviting (79%). Compared to the control group, specific knowledge and attitude did not substantially differ. Patients in the intervention group had a slightly more positive attitude about 'being attentive to signs indicating pneumonia' (median difference, 1 point; p=.003) and they also answered 'UTI is mostly caused by a bacteria' more often correctly (risk difference, 18%; 95% CI, 4-33%, p=.016).
  
  
  CONCLUSIONS
  A leaflet on prevention and treatment of LRTIs and UTIs is considered acceptable among DM2 patients, but a multi-faceted educational approach may be needed to improve health behavioral determinants.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands. lvenmans@gmail.com
authors.forename: Leonie M A J
authors.initials: LM
authors.lastname: Venmans
authors.forename: Kees J
authors.initials: KJ
authors.lastname: Gorter
authors.forename: Kim P
authors.initials: KP
authors.lastname: Baard
authors.forename: Guy E H M
authors.initials: GE
authors.lastname: Rutten
authors.forename: Eelko
authors.initials: E
authors.lastname: Hak
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D010353:Patient Education as Topic; D011320:Primary Health Care; D012141:Respiratory Tract Infections / Q000523:psychology / Q000628:therapy; D012424:Rural Population; D014505:Urban Population; D014552:Urinary Tract Infections / Q000523:psychology / Q000628:therapy