Evaluating the efficacy of an empowerment-based self-management consultant intervention: results of a two-year randomized controlled trial

Objectives: This study was conducted to determine if an empowerment-based Diabetes Self-Management Consultant (DSMC) intervention was more effective than a group receiving Mailed metabolic Assessments Only (MAO) in improving diabetes-related quality of life and blood glucose control. Methods: A two-year clinical trial, in which 310 patients with type 2 diabetes were randomized to the DSMC intervention or the MAO group. The DSMC met with the patient to review the baseline assessments, then discussed this review with the patient and the patient's physician. Subsequently patients received monthly telephone calls from the DSMC who used the empowerment approach to help patients identify self-management problems, consider options, set goals and make adjustments to their diabetes self-management plans. Results: The Diabetes Self-Management Consultant (DSMC) intervention resulted in improvements in diabetes related quality of life (PAID) p = 0.008, the diabetes empowerment scale (DES-SF) p = 0.024, A1C p = 0.016, perceived understanding of diabetes p = 0.001 and satisfaction with diabetes care p = 0.019 as compared to the MAO group. Conclusion: The DSMC the intervention resulted in a broad array of modest diabetes related improvements. A promising area for future research would be to test the efficacy of combining an empowerment-based DSMC intervention with case management using algorithm-based medication adjustments for higher risk patients