Telephone coaching improves lifestyle choices among rural residents with diabetes

Telephone coaching helps improve the lifestyle behaviors of rural residents with diabetes, according to a study published in the January 2012 issue of Clinical Diabetes.

In the study, Washington State University (WSU) researchers designed an eight-week telephone coaching intervention program. Pharmacy students from WSU served as telephone lifestyle coaches to the 50 rural residents with diabetes.

During weekly phone calls to patients lasting 10 to 20 minutes, telephone coaches reviewed the patients' goals from the previous week. They then focused on helping patients attain their goals and set future goals.

Participants overwhelmingly valued the telephone support they received. More than 79 percent of participants agreed that their coach helped them understand how to better control their diabetes. Almost 73 percent said that their coach's encouragement was important in controlling their disease.

Researchers noted a slight change in the hemoglobin A1C of 1.3 percent for coaching subjects after the eight-week period. No changes in blood pressure were recorded.

Due to the short time frame of the program, more follow up is required to measure the true impact of telephone coaching on A1C levels among patients.

“Student pharmacist telephone coaching is an effective, low-cost method to improve self-management of diabetes among rural residents with diabetes,” wrote the authors of the research article.

Motivational interviewing
The coaches in the study used motivational interviewing techniques to encourage lifestyle modifications. They reinforced positive change and encouraged further change.

They also used a problem-solving approach to talk with patients about barriers to achieve their self-management goals. They helped identify solutions or broke down goals into smaller, more attainable steps.

Telephone coaches emphasized self management behaviors that could reduce the risk of diabetes complications. These include daily diabetes routines like implementing self-care strategies, regular monitoring of blood glucose, adhering to medication schedules, making healthy diet choices, and completing recommended physical activity regimens.

They also encouraged participants to get regular medical care to reduce the risk of complications from the disease.

Higher incidence in rural communities
Rural communities suffer from higher rates of diabetes and complications from the disease, according to the study. These diabetes “hot spots” have higher rates of hospitalizations for severe diabetes complications as well.

In Washington state's diabetes “hot spots,” 17 percent of residents 45 years of age or older are living with diabetes, compared to 8.6 percent statewide. In one remote rural community in that state, 40 percent of the population suffers from diabetes.

Source: Clinical Diabetes

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