title: Self-reported effects of attending the Health Foundation's Co-Creating Health self-management programme for patients with type 2 diabetes mellitus in London, England.
abstract: BACKGROUND
  The purpose of this study was to determine the impact of the Health Foundation's Co-Creating Health (CCH) group self-management programme (SMP) for adult patients with type 2 diabetes on patient activation and quality of life.
  
  
  METHODS
  We conducted a multisite longitudinal study of 283 patients (mean age 62.3 years, SD 11.1; 43% ethnic minority; 51% female). Primary outcomes were patient activation, and diabetes and health related quality of life. Secondary outcomes included health status, psychological distress, and self-management ability. Data were collected immediately before the first SMP session (baseline) and 6 months after completing the programme. Quantitative analyses were based on mixed models using intent-to-treat and per-protocol procedures.
  
  
  RESULTS
  Sixty percent of patients who signed up for SMP completed the programme. Patient activation significantly improved 6 months after the SMP (p < 0.0001), and 60.2% of course completers showed meaningful improvement. Diabetes-related quality of life also improved significantly 6 months post course (p < 0.0001). About a quarter of SMP completers showed substantial improvement in self-management skills.
  
  
  CONCLUSIONS
  Attending the UK SMP for adults with type 2 diabetes leads to improvements in patient activation, diabetes-related quality of life, and improved confidence and ability to self-manage their condition. Improvement in patient activation is an important finding because activated patients participate in collaborative decision-making with their clinicians, report improved health-related behaviours and clinical outcomes, and better adhere to treatment.
authors.affiliation: Coventry University, Coventry, United Kingdom.
authors.forename: Joanna P
authors.initials: JP
authors.lastname: Kosmala-Anderson
authors.affiliation: Coventry University, Coventry, United Kingdom.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Wallace
authors.affiliation: Coventry University, Coventry, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Turner
authors.affiliation: Coventry University, Coventry, United Kingdom.
authors.forename: Claire
authors.initials: C
authors.lastname: Bourne
keywords: patient activation; self-management; type 2 diabetes