title: Low attendance at structured education for people with newly diagnosed type 2 diabetes: General practice characteristics and individual patient factors predict uptake.
abstract: OBJECTIVE
  The aims were to determine the association between individual and neighbourhood factors and attendance at structured education amongst people with newly diagnosed type 2 diabetes (T2DM).
  
  
  METHODS
  Multi-level analysis of questionnaire data from a prospective cohort of adults newly diagnosed T2DM. Setting was primary care, London, UK. Main outcome was attendance at structured education within 2 years.
  
  
  RESULTS
  Of 1790 people recruited, attendance data were available for 1626 (91%). Only 22.4% (n=365/1626) attended education. Attendance was independently associated with female gender (OR 1.28, 95% CI 1.05-1.46), lower HbA1c (OR 0.98 mmol/mol 95% CI 0.97-0.99) and non-smoker status (OR 1.36, 95% CI 1.07-1.55). General practice covariates, achievement of primary care targets for glycaemic control (OR 1.05, 95% C.I. 1.01-1.08) and recording of retinal screening (OR 0.96, 95% C.I. 0.93-0.99) were independently associated with attendance but unexplained general practice clustering accounted for 17% of the variance.
  
  
  CONCLUSIONS
  Education uptake is low amongst people with new onset T2DM. Attenders are more likely to be female, non-smokers with better HbA1c. General practices achieving glycaemic targets are more likely to have patients who attend education.
  
  
  CONCLUSIONS
  Strategies are needed to improve attendance at structured diabetes education particularly amongst hard to reach groups.
authors: Dept of Psychological Medicine, King's College London & Institute of Psychiatry, Psychology & Neuroscience, London, UK. Electronic address: kirsty.winkley@nhs.net.
authors: Kirsty
authors: K
authors: Winkley
authors: Dept of Biostatistics, King's College London & Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors: Daniel
authors: D
authors: Stahl
authors: Lambeth Diabetes Clinical Lead, Crown Dale Medical Centre, Lambeth, London, UK.
authors: Mark
authors: M
authors: Chamley
authors: Dept of Psychological Medicine, King's College London & Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors: Rosanna
authors: R
authors: Stopford
authors: Dept of Diabetes & Nutrition, King's College London & School of Medicine, London, UK.
authors: Monica
authors: M
authors: Boughdady
authors: Dept of Diabetes & Endocrinology, Guy's & St Thomas' NHS Foundation Trust, London, UK.
authors: Stephen
authors: S
authors: Thomas
authors: Dept of Diabetes & Nutrition, King's College London & School of Medicine, London, UK.
authors: Stephanie A
authors: SA
authors: Amiel
authors: Dept of Primary and Intermediate Care, King's College London & Nightingale School of Nursing & Midwifery, London, UK.
authors: Angus
authors: A
authors: Forbes
authors: Dept of Psychological Medicine, King's College London & Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors: Khalida
authors: K
authors: Ismail
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D005260:Female; D058006:General Practice; D006297:Health Services Accessibility; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D009042:Motivation; D055361:Multilevel Analysis; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011446:Prospective Studies; D012648:Self Care; D017678:Sex Distribution; D011795:Surveys and Questionnaires
keywords: Attendance; Education; General practice; Primary health care; Type 2 diabetes mellitus; Uptake