title: Effect of hospital-based telephone coaching on glycaemic control and adherence to management guidelines in type 2 diabetes, a randomised controlled trial.
abstract: BACKGROUND
  Failure to achieve treatment targets is common among people with type 2 diabetes. Cost-effective treatments are required to delay the onset and slow the progression of diabetes-related complications.
  
  
  OBJECTIVE
  This study aimed to measure the effect of a 6-month telephone coaching intervention on glycaemic control, risk factor status and adherence to diabetes management practices at the intervention's conclusion (6 months) and at 12 months.
  
  
  METHODS
  This randomised controlled trial recruited 94 adults with type 2 diabetes and an HbA1C > 7% from the Diabetes Clinic of St Vincent's Hospital Melbourne. People who were non-English speaking, cognitively impaired, severely hearing impaired or without telephone access were excluded. Participants were randomised to receive usual care plus 6 months of telephone coaching focusing on achieving treatment targets and complication screening, or usual care only. The primary outcome was HbA1C at 6 months; secondary outcomes included other physiological and monitoring measures.
  
  
  RESULTS
  Significant interaction effects were observed between group and time at 6 months, demonstrating improvement in HbA1C, fasting glucose, diastolic blood pressure and physical activity. The intervention's effect on these parameters was not sustained at 12 months. Intervention group participants also improved compliance with foot examinations and pneumococcal vaccination by 6 months and retinal screening by 12 months.
  
  
  CONCLUSIONS
  Telephone coaching improved glycaemic control and adherence to complication screening in people with type 2 diabetes, for the duration of its delivery, but these effects were not maintained on withdrawal of the intervention. Strategies that assist patients to sustain these benefits are required.
authors: Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia; Restoring Health, St Vincent's Hospital, Melbourne, Victoria, Australia.
authors: J E
authors: JE
authors: Varney
authors: T J
authors: TJ
authors: Weiland
authors: W J
authors: WJ
authors: Inder
authors: G A
authors: GA
authors: Jelinek
mesh_terms: D000368:Aged; D001315:Australia / Q000453:epidemiology; D015190:Blood Glucose Self-Monitoring / Q000523:psychology*; D003362:Cost-Benefit Analysis; D048909:Diabetes Complications / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000706:statistics & numerical data; D012648:Self Care / Q000523:psychology; D011795:Surveys and Questionnaires; D013689:Telephone
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: diabetes complication; diabetes mellitus; guideline adherence; patient education; randomised controlled trial; type 2