Effectiveness of general practice based, practice nurse led telephone coaching on glycaemic control of type 2 diabetes: The Patient Engagement and Coaching for Health (PEACH) pragmatic cluster randomised controlled trial

Irene D. Blackberry, John S. Furler, James D. Best, Patty Chondros, Margarite Vale, Christine Walker, Trisha Dunning, Leonie Segal, James Dunbar, Ralph Audehm, Danny Liew, Doris Young

    Research output: Contribution to journalArticle

    45 Citations (Scopus)

    Abstract

    Objective: To evaluate the effectiveness of goal focused telephone coaching by practice nurses in improving glycaemic control in patients with type 2 diabetes in Australia. Design: Prospective, cluster randomised controlled trial, with general practices as the unit of randomisation. Setting: General practices in Victoria, Australia. Participants 59 of 69 general practices that agreed to participate recruited sufficient patients and were randomised. Of 829 patients with type 2 diabetes (glycated haemoglobin (HbA1c) >7.5% in the past 12 months) who were assessed for eligibility, 473 (236 from 30 intervention practices and 237 from 29 control practices) agreed to participate. Intervention: Practice nurses from intervention practices received two days of training in a telephone coaching programme, which aimed to deliver eight telephone and one face to face coaching episodes per patient. Main outcome measures: The primary end point was mean absolute change in HbA1c between baseline and 18 months in the intervention group compared with the control group. Results: The intervention and control patients were similar at baseline. None of the practices dropped out over the study period; however, patient attrition rates were 5% in each group (11/236 and 11/237 in the intervention and control group, respectively). The median number of coaching sessions received by the 236 intervention patients was 3 (interquartile range 1-5), of which 25% (58/236) did not receive any coaching sessions. At 18 months' follow-up the effect on glycaemic control did not differ significantly (mean difference 0.02, 95% confidence interval-0.20 to 0.24, P=0.84) between the intervention and control groups, adjusted for HbA1c measured at baseline and the clustering. Other biochemical and clinical outcomes were similar in both groups. Conclusions: A practice nurse led telephone coaching intervention implemented in the real world primary care setting produced comparable outcomes to usual primary care in Australia. The addition of a goal focused coaching role onto the ongoing generalist role of a practice nurse without prescribing rights was found to be ineffective.

    LanguageEnglish
    Article numberf5272
    JournalBMJ (Online)
    Volume347
    Issue number7926
    DOIs
    Publication statusPublished - 28 Sep 2013

    ASJC Scopus subject areas

    • Medicine(all)

    Cite this

    Blackberry, Irene D. ; Furler, John S. ; Best, James D. ; Chondros, Patty ; Vale, Margarite ; Walker, Christine ; Dunning, Trisha ; Segal, Leonie ; Dunbar, James ; Audehm, Ralph ; Liew, Danny ; Young, Doris. / Effectiveness of general practice based, practice nurse led telephone coaching on glycaemic control of type 2 diabetes : The Patient Engagement and Coaching for Health (PEACH) pragmatic cluster randomised controlled trial. In: BMJ (Online). 2013 ; Vol. 347, No. 7926.
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    title = "Effectiveness of general practice based, practice nurse led telephone coaching on glycaemic control of type 2 diabetes: The Patient Engagement and Coaching for Health (PEACH) pragmatic cluster randomised controlled trial",
    abstract = "Objective: To evaluate the effectiveness of goal focused telephone coaching by practice nurses in improving glycaemic control in patients with type 2 diabetes in Australia. Design: Prospective, cluster randomised controlled trial, with general practices as the unit of randomisation. Setting: General practices in Victoria, Australia. Participants 59 of 69 general practices that agreed to participate recruited sufficient patients and were randomised. Of 829 patients with type 2 diabetes (glycated haemoglobin (HbA1c) >7.5{\%} in the past 12 months) who were assessed for eligibility, 473 (236 from 30 intervention practices and 237 from 29 control practices) agreed to participate. Intervention: Practice nurses from intervention practices received two days of training in a telephone coaching programme, which aimed to deliver eight telephone and one face to face coaching episodes per patient. Main outcome measures: The primary end point was mean absolute change in HbA1c between baseline and 18 months in the intervention group compared with the control group. Results: The intervention and control patients were similar at baseline. None of the practices dropped out over the study period; however, patient attrition rates were 5{\%} in each group (11/236 and 11/237 in the intervention and control group, respectively). The median number of coaching sessions received by the 236 intervention patients was 3 (interquartile range 1-5), of which 25{\%} (58/236) did not receive any coaching sessions. At 18 months' follow-up the effect on glycaemic control did not differ significantly (mean difference 0.02, 95{\%} confidence interval-0.20 to 0.24, P=0.84) between the intervention and control groups, adjusted for HbA1c measured at baseline and the clustering. Other biochemical and clinical outcomes were similar in both groups. Conclusions: A practice nurse led telephone coaching intervention implemented in the real world primary care setting produced comparable outcomes to usual primary care in Australia. The addition of a goal focused coaching role onto the ongoing generalist role of a practice nurse without prescribing rights was found to be ineffective.",
    author = "Blackberry, {Irene D.} and Furler, {John S.} and Best, {James D.} and Patty Chondros and Margarite Vale and Christine Walker and Trisha Dunning and Leonie Segal and James Dunbar and Ralph Audehm and Danny Liew and Doris Young",
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    Effectiveness of general practice based, practice nurse led telephone coaching on glycaemic control of type 2 diabetes : The Patient Engagement and Coaching for Health (PEACH) pragmatic cluster randomised controlled trial. / Blackberry, Irene D.; Furler, John S.; Best, James D.; Chondros, Patty; Vale, Margarite; Walker, Christine; Dunning, Trisha; Segal, Leonie; Dunbar, James; Audehm, Ralph; Liew, Danny; Young, Doris.

    In: BMJ (Online), Vol. 347, No. 7926, f5272, 28.09.2013.

    Research output: Contribution to journalArticle

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    T1 - Effectiveness of general practice based, practice nurse led telephone coaching on glycaemic control of type 2 diabetes

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    AU - Furler, John S.

    AU - Best, James D.

    AU - Chondros, Patty

    AU - Vale, Margarite

    AU - Walker, Christine

    AU - Dunning, Trisha

    AU - Segal, Leonie

    AU - Dunbar, James

    AU - Audehm, Ralph

    AU - Liew, Danny

    AU - Young, Doris

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    N2 - Objective: To evaluate the effectiveness of goal focused telephone coaching by practice nurses in improving glycaemic control in patients with type 2 diabetes in Australia. Design: Prospective, cluster randomised controlled trial, with general practices as the unit of randomisation. Setting: General practices in Victoria, Australia. Participants 59 of 69 general practices that agreed to participate recruited sufficient patients and were randomised. Of 829 patients with type 2 diabetes (glycated haemoglobin (HbA1c) >7.5% in the past 12 months) who were assessed for eligibility, 473 (236 from 30 intervention practices and 237 from 29 control practices) agreed to participate. Intervention: Practice nurses from intervention practices received two days of training in a telephone coaching programme, which aimed to deliver eight telephone and one face to face coaching episodes per patient. Main outcome measures: The primary end point was mean absolute change in HbA1c between baseline and 18 months in the intervention group compared with the control group. Results: The intervention and control patients were similar at baseline. None of the practices dropped out over the study period; however, patient attrition rates were 5% in each group (11/236 and 11/237 in the intervention and control group, respectively). The median number of coaching sessions received by the 236 intervention patients was 3 (interquartile range 1-5), of which 25% (58/236) did not receive any coaching sessions. At 18 months' follow-up the effect on glycaemic control did not differ significantly (mean difference 0.02, 95% confidence interval-0.20 to 0.24, P=0.84) between the intervention and control groups, adjusted for HbA1c measured at baseline and the clustering. Other biochemical and clinical outcomes were similar in both groups. Conclusions: A practice nurse led telephone coaching intervention implemented in the real world primary care setting produced comparable outcomes to usual primary care in Australia. The addition of a goal focused coaching role onto the ongoing generalist role of a practice nurse without prescribing rights was found to be ineffective.

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