Implementation of a lifestyle intervention for type 2 diabetes prevention in Dutch primary care

Autor: Jos D M Schelfhout, P. W. A. Vermunt, F. Wielaard, Caroline A. Baan, Ivon E J Milder, Gert P. Westert, Hans van Oers
Přispěvatelé: Tranzo, Scientific center for care and wellbeing
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Counseling
Male
Lifestyle intervention
Research design
Program evaluation
Health Knowledge
Attitudes
Practice
medicine.medical_specialty
Health Behavior
Psychological intervention
Patient satisfaction
Nursing
Surveys and Questionnaires
Intervention (counseling)
Humans
Medicine
Nurse Practitioners
Life Style
Reimbursement
Incentive
Reimbursement
Netherlands
Physician-Patient Relations
lcsh:R5-920
Primary Health Care
Delivery of Health Care
Integrated
business.industry
Health Plan Implementation
Attendance
Physicians
Family
Type 2 diabetes
Middle Aged
Primary care
Diabetes Mellitus
Type 2
Patient Satisfaction
Research Design
Implementation
Family medicine
Workforce
Patient Compliance
Female
lcsh:Medicine (General)
Quality of hospital and integrated care [NCEBP 4]
Family Practice
business
Risk Reduction Behavior
Program Evaluation
Research Article
Zdroj: BMC Family Practice, 13:79. BioMed Central
BMC Family Practice, 13
BMC Family Practice, Vol 13, Iss 1, p 79 (2012)
BMC Family Practice
ISSN: 1471-2296
Popis: Contains fulltext : 108251.pdf (Publisher’s version ) (Open Access) BACKGROUND: As in clinical practice resources may be limited compared to experimental settings, translation of evidence-based lifestyle interventions into daily life settings is challenging. In this study we therefore evaluated the implementation of the APHRODITE lifestyle intervention for the prevention of type 2 diabetes in Dutch primary care. Based on this evaluation we discuss opportunities for refining intervention delivery. METHODS: A 2.5-year intervention was performed in 14 general practices in the Netherlands among individuals at high risk for type 2 diabetes (FINDRISC-score >/= 13) (n = 479) and was compared to usual care (n = 446). Intervention consisted of individual lifestyle counselling by nurse practitioners (n = 24) and GPs (n = 48) and group-consultations. Drop-out and attendance were registered during the programme. After the intervention, satisfaction with the programme and perceived implementation barriers were assessed with questionnaires. RESULTS: Drop-out was modest (intervention: 14.6 %; usual care: 13.2 %) and attendance at individual consultations was high (intervention: 80-97 %; usual care: 86-94 %). Providers were confident about diabetes prevention by lifestyle intervention in primary care. Participants were more satisfied with counselling from nurse practitioners than from GPs. A major part of the GPs reported low self-efficacy regarding dietary guidance. Lack of counselling time (60 %), participant motivation (12 %), and financial reimbursement (11 %) were regarded by providers as important barriers for intervention implementation. CONCLUSIONS: High participant compliance and a positive attitude of providers make primary care a suitable setting for diabetes prevention by lifestyle counselling. Results support a role for the nurse practitioner as the key player in guiding lifestyle modification. Further research is needed on strategies that could increase cost-effectiveness, such as more stringent criteria for participant inclusion, group-counselling, more tailor-made counselling and integration of screening and / or interventions for different disorders.
Databáze: OpenAIRE
Externí odkaz: