Does patient education facilitate diabetic patients' possibilities to reach national treatment targets? A national survey in Swedish primary healthcare.

摘要

OBJECTIVE: To describe how patient education is arranged in Swedish primary healthcare (PHC) and to assess whether the type of patient education and individual goal setting have an impact on diabetic patients' possibilities of reaching national treatment targets. DESIGN: A Swedish national survey. SETTING: Swedish PHC. SUBJECTS: Data from 485 primary healthcare centres (PHCCs) and 91,637 diabetic patients reported by the PHCCs to the National Diabetes Register in 2006. MAIN OUTCOME MEASURES: Description of how patient education is arranged, HbA(1c), body mass index, cholesterol, blood pressure, and physical activity. RESULTS: Of the PHCCs that reported how they performed the individual counselling, 50% reported checklist-driven counselling and 8% individualized counselling based on patients' needs. A total of 105 PHCCs reported that they arranged group education. Of these, 67% used pre-planned programmes and 9% individualized the programme to the patients' needs. The majority of PHCCs (96%) reported that they set individual goals (HbA(1c), blood pressure, lipids, and lifestyle). A minority of the PHCCs (27%) reported that the patients were involved in the final decision concerning their goals. Individual goal-setting facilitated patients' possibilities of reaching treatment targets. Goal-setting, list size of PHCCs, and personnel resources explained a variance of 2.1-5.7%. Neither individual counselling (checklist-driven or individualized to patients' needs) nor group education had an impact on patients' possibilities of reaching the targets. CONCLUSION: The current study indicates that improvement is needed in patient education in PHC to facilitate diabetic patients' possibilities of reaching national treatment targets.