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Shashua A1, Levran I1
1Clalit Health Services, Physiotherapy, Tel Aviv, Israel
Background: Diabetes Mellitus type 2 (DM2) is a metabolic disorder affected by the patient´s lifestyle. In Clalit, the biggest health-care organization in Israel with 4.5 million members, 30,000 diabetic patients attend to physical therapy (PT) clinics due to musculo-skeletal disorders within a year. PT treatment is primarily targeted at functional rehabilitation, active approach supported, which is in part similar to the recommended intervention for DM2. It is reasonable to assume that the functional improvement directed at musculo-skeletal disorder will affect the diabetes indicators as well. There is a need for educational and self-management programs for DM2 patients.
Purpose:
1. Creating an educational intervention model for diabetic patients, integrated into the routine treatment program, among patients referred to PT clinics with musculo-skeletal disorders.
2. Improving functional status, quality of life, and diabetic indicators of these patients.
Methods: A secondary analysis of a cohort study, based on Clalits´ big data warehouse, among patients who attended PT treatment for low back pain was conducted. Diabetic participants were identified by ICD9 codes and descriptive statistics was performed to compare rates of function and pain improvement between diabetic and non-diabetic participants.
During 2017-2018, sixteen physiotherapists were selected for the position of diabetes educators and went through a prolonged comprehensive training program, providing information about DM2, principles of self-management and therapeutic education.
Results: Among 54,767 participants in the primary cohort study, 7,902 were identified as diabetic. Improvement in functional and pain status, as well as decrease in analgesic drugs consumption, was observed in similar proportion among diabetic and non-diabetic patients.
At the end of the diabetes educators´ training program a role definition was defined and an implementation program was set. A unique treatment code for diabetes education was established in the medical record.
Several guidelines were defined:
ü The diabetes educators will provide education and self-management strategies for diabetic patients.
ü Diabetes education will be integrated into the routine episode of care among patients referred to PT treatment with musculo-skeletal disorders
ü The diabetes-educator should train other physiotherapists and disseminate the information among primary care providers and general population.
Conclusion(s): Routine PT treatment, directed at musculo-skeletal disorders, improves functional and pain levels of patients with DM2. By minor adjustments, through educational intervention model, additional improvement in their quality of life and diabetes indicators may be achieved.
A follow-up research is needed to assess the outcomes of diabetes education and to allow establishing an organizational structural health policy program.
Implications: The health-care system worldwide provides intervention programs for diabetic patients to improve their health condition and quality of life. Although good results, the ability to expose a broad population of DM2 patients for these programs is limited, and the rate of participants is low. However, The PT array has the infrastructure, the skills, the knowledge, and the patients to achieve these goals. Therapeutic education, provided by physiotherapists who have been trained as diabetes educators, as a part of the routine functional rehabilitation, may significantly improve the quality of life of thousands of patients each year and become the largest diabetes project ever produced.
Keywords: Diabetes Mellitus type 2, therapeutic education, physical therapy
Funding acknowledgements: There were no sources of support or financial involvement in any organization or entity.
Purpose:
1. Creating an educational intervention model for diabetic patients, integrated into the routine treatment program, among patients referred to PT clinics with musculo-skeletal disorders.
2. Improving functional status, quality of life, and diabetic indicators of these patients.
Methods: A secondary analysis of a cohort study, based on Clalits´ big data warehouse, among patients who attended PT treatment for low back pain was conducted. Diabetic participants were identified by ICD9 codes and descriptive statistics was performed to compare rates of function and pain improvement between diabetic and non-diabetic participants.
During 2017-2018, sixteen physiotherapists were selected for the position of diabetes educators and went through a prolonged comprehensive training program, providing information about DM2, principles of self-management and therapeutic education.
Results: Among 54,767 participants in the primary cohort study, 7,902 were identified as diabetic. Improvement in functional and pain status, as well as decrease in analgesic drugs consumption, was observed in similar proportion among diabetic and non-diabetic patients.
At the end of the diabetes educators´ training program a role definition was defined and an implementation program was set. A unique treatment code for diabetes education was established in the medical record.
Several guidelines were defined:
ü The diabetes educators will provide education and self-management strategies for diabetic patients.
ü Diabetes education will be integrated into the routine episode of care among patients referred to PT treatment with musculo-skeletal disorders
ü The diabetes-educator should train other physiotherapists and disseminate the information among primary care providers and general population.
Conclusion(s): Routine PT treatment, directed at musculo-skeletal disorders, improves functional and pain levels of patients with DM2. By minor adjustments, through educational intervention model, additional improvement in their quality of life and diabetes indicators may be achieved.
A follow-up research is needed to assess the outcomes of diabetes education and to allow establishing an organizational structural health policy program.
Implications: The health-care system worldwide provides intervention programs for diabetic patients to improve their health condition and quality of life. Although good results, the ability to expose a broad population of DM2 patients for these programs is limited, and the rate of participants is low. However, The PT array has the infrastructure, the skills, the knowledge, and the patients to achieve these goals. Therapeutic education, provided by physiotherapists who have been trained as diabetes educators, as a part of the routine functional rehabilitation, may significantly improve the quality of life of thousands of patients each year and become the largest diabetes project ever produced.
Keywords: Diabetes Mellitus type 2, therapeutic education, physical therapy
Funding acknowledgements: There were no sources of support or financial involvement in any organization or entity.
Topic: Health promotion & wellbeing/healthy ageing; Professional practice: other; Non-communicable diseases (NCDs) & risk factors
Ethics approval required: Yes
Institution: Clalit Health Services
Ethics committee: Clalit ethical review board
Ethics number: 0036-15-COM
All authors, affiliations and abstracts have been published as submitted.
