Evaluating the Effect of a Diabetes Health Coach in Individuals with Type 2 Diabetes

      Abstract

      Objectives

      Diabetes health coaching has not been adequately assessed in individuals with type 2 diabetes. The objective of this review was to synthesize the evidence of health coaching for individuals with diabetes to determine the effects of coaching on diabetes control, specifically on glycated hemoglobin (A1C) levels.

      Methods

      The EMBASE, MEDLINE, CINAHL, PsychINFO and Cochrane Central Register of Controlled Trials databases were searched from inception to January 2015. Reference lists from important publications were also reviewed. At least 2 evaluators independently screened and extracted data from eligible studies.

      Results

      A total of 8 trials met the selection criteria, which included 724 adult participants; 353 participants were randomized to a diabetes health coaching intervention, and 371 were randomized to usual care. The pooled effect of diabetes health coaching overall was a statistically significant reduction of A1C levels by 0.32 (95% CI, −0.50 to −0.15). Longer diabetes health coaching exposure (>6 months) resulted in a 0.57% reduction in A1C levels (95% CI, −0.76 to −0.38), compared to shorter diabetes health coaching exposure (≤6 months) (−0.23%; 95% CI, −0.37 to −0.09). Across all studies, diabetes health coaching consisted of goal setting, knowledge acquisition, individualized care and frequent follow up.

      Conclusions

      Diabetes health coaching has an emerging role in healthcare that facilitates self-care, behaviour change and offers frequent follow up and support. This review finds that health coaching for those with diabetes is an effective intervention for improving glycemic control, which may be of greater benefit when offered in addition to existing diabetes care.

      Résumé

      Objectifs

      L'accompagnement en santé de la personne diabétique n'a pas été bien évalué chez les individus souffrant du diabète de type 2. L'objectif de cette revue était de synthétiser les données scientifiques sur l'accompagnement en santé des individus diabétiques pour déterminer les effets de l'accompagnement sur la maîtrise du diabète, particulièrement sur les taux d'hémoglobine glyquée (A1c).

      Méthodes

      Nous avons consulté les bases de données EMBASE, MEDLINE, CINAHL, PsychINFO et Cochrane Central Register of Controlled Trials de leur création à janvier 2015. Nous avons passé en revue les listes de références de publications importantes. Au moins 2 évaluateurs ont examiné et extrait de manière indépendante les données des études admissibles.

      Résultats

      Parmi les 724 participants adultes provenant de 8 essais qui répondaient aux critères de sélection, nous avons réparti aléatoirement 353 participants à l'accompagnement en santé de la personne diabétique et 371 participants aux soins habituels. Dans l'ensemble, l'effet groupé de l'accompagnement en santé de la personne diabétique montrait une réduction statistiquement significative des taux d'A1c de 0,32 (IC à 95%, −0,50 à −0,15). Une plus longue durée d'accompagnement en santé de la personne diabétique (>6 mois) entraînait une réduction des taux d'A1C de 0,57% (IC à 95%, −0,76 à −0,38), alors qu'une plus courte durée d'accompagnement en santé de la personne diabétique (≤6 mois) entraînait une réduction de 0,23% (IC à 95%, −0,37 à −0,09). Dans toutes les études, l'accompagnement en santé de la personne diabétique consistait à établir des objectifs, à acquérir de connaissances, et à offrir des soins individualisés et un suivi fréquent.

      Conclusions

      Le nouveau rôle que l'accompagnement en santé de la personne diabétique joue dans les soins de santé facilite l'autonomie en matière de santé et la modification du comportement, et offre un suivi fréquent et du soutien. Cette revue démontre que l'accompagnement en santé des personnes diabétiques est une intervention efficace pour améliorer la régulation de la glycémie et qu'il peut se révéler plus avantageux lorsqu'il est offert en plus des soins actuels du diabète.

      Keywords

      Mots clés

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