Telephone Counseling May Help Diabetes Patients Lower A1c

Counseling calls covered medication adherence strategies, healthy eating, increasing physical activity, stress management, and the importance of patient-physician discussion

Telephone counseling provided by health educators may help people with diabetes lower their A1c levels, according to data from the Bronx A1c Telephonic Behavioral Intervention Study.

In the study, 941 adults with diabetes from diverse backgrounds who had an A1c of greater than 7% in the New York City Health Department’s A1c Registry were randomly assigned to receive telephone counseling sessions and four mailings of print materials or only the mailings of print materials for one year, reported Elizabeth A. Walker, PhD, professor in the Department of Medicine (Endocrinology) and the Department of Epidemiology and Population Health at the Albert Einstein College of Medicine in New York.

Dr. Walker presented the research at the American Diabetes Association’s 73rd Scientific Sessions, held in Chicago.

Counseling calls covered medication adherence strategies, healthy eating, increasing physical activity, stress management, and the importance of patient-physician discussion. Participants in the telephone group received four to eight calls depending on their A1c levels at baseline. Print materials included items from the National Diabetes Prevention Program website and items the researchers developed or adapted for monitoring medication adherence, food, and activity.

“Almost all items were free online, but we mailed them to patients in the study,” said Dr. Walker in an interview with DiabeticLifestyle.

Among the participants, 70% were foreign-born, 68% were Hispanic, 28% were non-Hispanic black, and 56% spoke Spanish. “Only patients who spoke and read English or Spanish were eligible for the study,” said Dr. Walker.

The mean A1c among all participants was 9.2%. The main outcome was change in A1c from baseline to one year, which the researchers extracted from the A1c Registry.

At study’s end, participants in the telephone counseling group had a decline in A1c of 0.39% more than those who only received print materials. Further analysis of the data revealed that the effect of the intervention was not mediated by measures of medication adherence, diabetes distress, depression, self-care behaviors, or well-being.

Dr. Walker noted that data analysis is ongoing. However, she speculated that the encouraging nature of the phone counseling may have played a role in the greater decline in A1c in the telephone intervention group. “The calls were tailored to the individuals’ concerns and needs. We were trying to promote self-confidence with self-management.”

Dr. Walker disclosed no conflicts of interest.

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