Item #1
A1c
Refrigerator Poster Lowers HbA1c 25%
Posting
the results of a patients A1c on the refrigerator with their goals
becomes an effective tool to help self-manage a patient with
diabetes
OBJECTIVE—The
public is increasingly aware of the importance of HbA1c
testing, yet the vast majority of patients with diabetes do
not know their HbA1c status or goal. We set forth to
evaluate the impact of a system that provides uniquely
formatted and personalized reports of diabetes status
and goals on changes in HbA1c levels.
RESEARCH
DESIGN AND METHODS—A
total of 150 patients with diabetes were randomized to
receive either standard care or intervention inclusive
of a computer-generated 11" x 17" color poster
depicting an individual’s HbA1c status and goals
along with personalized steps to aid in goal achievement.
All patients enrolled received diabetes education
during the 3 months before enrollment. HbA1c
was performed at baseline and 6 months.
RESULTS—At
baseline, there were no significant differences between
patient groups in terms of age, sex, education level, race,
and HbA1c or lipid levels. Among patients with baseline
HbA1c
 7.0%,
there was an 8.6% (0.77% absolute) reduction in HbA1c
among control subjects compared with a 17.0% (1.69% absolute)
decline in the intervention group (P = 0.032). There
were no differences between the control and
intervention groups with respect to the frequency of
patients experiencing any decline in HbA1c
(63 vs. 69%, P = 0.87); among these patients experiencing
a decline, the most substantial reductions were seen with
the control group, which had a 13.3% (1.15% absolute)
decline compared with the intervention patients, who
reduced their HbA1c by 24.2% (2.26% absolute
reduction; P = 0.0048). At study close, 77% of
the patients had their poster displayed on their refrigerator.
CONCLUSIONS—This
unique and personalized computer-generated intervention
resulted in HbA1c lowering comparable to that of hypoglycemic
agents. Diabetes Care
25:2-8, 2002
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