title: Randomised controlled trial of an automated, interactive telephone intervention (TLC Diabetes) to improve type 2 diabetes management: baseline findings and six-month outcomes.
abstract: BACKGROUND
  Effective self-management of diabetes is essential for the reduction of diabetes-related complications, as global rates of diabetes escalate.
  
  
  METHODS
  Randomised controlled trial. Adults with type 2 diabetes (n = 120), with HbA1c greater than or equal to 7.5 %, were randomly allocated (4 × 4 block randomised block design) to receive an automated, interactive telephone-delivered management intervention or usual routine care. Baseline sociodemographic, behavioural and medical history data were collected by self-administered questionnaires and biological data were obtained during hospital appointments. Health-related quality of life (HRQL) was measured using the SF-36.
  
  
  RESULTS
  The mean age of participants was 57.4 (SD 8.3), 63% of whom were male. There were no differences in demographic, socioeconomic and behavioural variables between the study arms at baseline. Over the six-month period from baseline, participants receiving the Australian TLC (Telephone-Linked Care) Diabetes program showed a 0.8% decrease in geometric mean HbA(1c) from 8.7% to 7.9%, compared with a 0.2% HbA(1c) reduction (8.9% to 8.7%) in the usual care arm (p = 0.002). There was also a significant improvement in mental HRQL, with a mean increase of 1.9 in the intervention arm, while the usual care arm decreased by 0.8 (p = 0.007). No significant improvements in physical HRQL were observed.
  
  
  CONCLUSIONS
  These analyses indicate the efficacy of the Australian TLC Diabetes program with clinically significant post-intervention improvements in both glycaemic control and mental HRQL. These observed improvements, if supported and maintained by an ongoing program such as this, could significantly reduce diabetes-related complications in the longer term. Given the accessibility and feasibility of this kind of program, it has strong potential for providing effective, ongoing support to many individuals with diabetes in the future.
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. emily.d.williams@monash.edu
authors.forename: Emily D
authors.initials: ED
authors.lastname: Williams
authors.forename: Dominique
authors.initials: D
authors.lastname: Bird
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Forbes
authors.forename: Anthony
authors.initials: A
authors.lastname: Russell
authors.forename: Susan
authors.initials: S
authors.lastname: Ash
authors.forename: Robert
authors.initials: R
authors.lastname: Friedman
authors.forename: Paul A
authors.initials: PA
authors.lastname: Scuffham
authors.forename: Brian
authors.initials: B
authors.lastname: Oldenburg
mesh_terms: D000328:Adult; D001315:Australia; D054626:Consumer Health Information; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D015444:Exercise / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000379:methods*; D011788:Quality of Life; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000295:instrumentation; D013689:Telephone; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin