Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Research article

Randomised controlled trial of an automated, interactive telephone intervention (TLC Diabetes) to improve type 2 diabetes management: baseline findings and six-month outcomes

Emily D Williams1*, Dominique Bird1, Andrew W Forbes1, Anthony Russell23, Susan Ash4, Robert Friedman5, Paul A Scuffham6 and Brian Oldenburg1

Author Affiliations

1 School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

2 School of Medicine, University of Queensland, Brisbane, Australia

3 Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Australia

4 Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia

5 School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia

6 Centre for Applied Health Economics, School of Medicine, Griffith Health Institute, Griffith University, Queensland, Australia

For all author emails, please log on.

BMC Public Health 2012, 12:602  doi:10.1186/1471-2458-12-602

Published: 3 August 2012

Abstract

Background

Effective self-management of diabetes is essential for the reduction of diabetes-related complications, as global rates of diabetes escalate.

Methods

Randomised controlled trial. Adults with type 2 diabetes (n = 120), with HbA1c greater than or equal to 7.5 %, were randomly allocated (4 × 4 block randomised block design) to receive an automated, interactive telephone-delivered management intervention or usual routine care. Baseline sociodemographic, behavioural and medical history data were collected by self-administered questionnaires and biological data were obtained during hospital appointments. Health-related quality of life (HRQL) was measured using the SF-36.

Results

The mean age of participants was 57.4 (SD 8.3), 63% of whom were male. There were no differences in demographic, socioeconomic and behavioural variables between the study arms at baseline. Over the six-month period from baseline, participants receiving the Australian TLC (Telephone-Linked Care) Diabetes program showed a 0.8% decrease in geometric mean HbA1c from 8.7% to 7.9%, compared with a 0.2% HbA1c reduction (8.9% to 8.7%) in the usual care arm (p = 0.002). There was also a significant improvement in mental HRQL, with a mean increase of 1.9 in the intervention arm, while the usual care arm decreased by 0.8 (p = 0.007). No significant improvements in physical HRQL were observed.

Conclusions

These analyses indicate the efficacy of the Australian TLC Diabetes program with clinically significant post-intervention improvements in both glycaemic control and mental HRQL. These observed improvements, if supported and maintained by an ongoing program such as this, could significantly reduce diabetes-related complications in the longer term. Given the accessibility and feasibility of this kind of program, it has strong potential for providing effective, ongoing support to many individuals with diabetes in the future.