How effective are non-specialist clinicians, compared to psychological specialists, in delivering psychological interventions to improve glycaemic control in type 2 diabetes?

R. Alam, J. Sturt, K. Winkley, R. Lall, K. Ismail

    Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

    Abstract

    OBJECTIVE: To update a meta-analysis and determine the effectiveness of psychological interventions on glycaemic control measured by HbA(1c) and psychological status in type 2 diabetes and to compare effects when interventions are delivered by generalist clinicians compared to psychological specialists.METHODS: We used the original review protocol and searched the Cochrane central register of controlled trials, Medline, Embase, PsychLIT, and Google Scholar from February 2003 (end of previous review) to March 2007. We extracted data on the participants, interventions, delivery methods, comparison groups and outcome measures.RESULTS: 35 trials were reviewed and meta-analysis of 19 trials (n=1431), reporting HbA(1c) found a reduction in HbA(1c) by 0.54% (-0.32; 95% CI: -0.47 to -0.16). In nine trials (n=832) interventions were delivered by diabetes or general clinicians reducing HbA(1c) by 0.51% (-0.27; 95% CI: -0.50 to 0.04). In nine trials, interventions (n=561) were delivered by psychological specialists reducing HbA(1c) by 0.57% (-0.36; 95% CI: -0.61 to 0.12). Meta-analysis of 13 trials reporting psychological status found psychological status to be lower in the intervention groups -0.56 (95% CI: 1.00 to -0.13). Trial quality for the majority of studies remained poor.CONCLUSION: Our findings suggest that psychological and general clinicians are similarly effective in delivering psychological interventions, however, effect sizes for all clinicians have reduced since the earlier review.PRACTICE IMPLICATIONS: Psychological training opportunities for generalist clinicians could lead to wider availability of effective psychological care.
    Original languageEnglish
    Title of host publicationSW-SAPC Warwickshire
    Place of PublicationSW-SAPC Warwickshire
    PublisherSouth West Society for Academic Primary Care
    Publication statusPublished - 6 Mar 2008
    EventSouth Warwickshire Society for Academic Primary Care (SW-SAPC). - Woodland Grange Conference Centre, Leamington Spa, Warwickshire
    Duration: 6 Mar 20087 Mar 2008

    Conference

    ConferenceSouth Warwickshire Society for Academic Primary Care (SW-SAPC).
    CityWoodland Grange Conference Centre, Leamington Spa, Warwickshire
    Period6/03/087/03/08

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