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Reasons for Non-participation of Diabetes Patients in Structured Education Programmes: a Narrative Review

DOI: 10.3238/zfa.2021.0026-0031

german translation / full article

Lajos Benjamin Horvath, Nicolle Müller, Nadine Kuniss, Jutta Bleidorn, Sven Schulz

Keywords: checklist chronic disease evidence-based medicine family medicine general practice

BackgroundStructured treatment and education programs for patients with diabetes mellitus are an important part of the therapy. The aim is to transfer knowledge and practical skills. Numerous cohort studies and randomized controlled studies confirm the effectiveness of structured treatment and education programs. Nevertheless, the participation rates in structured treatment and education programs are still insufficient. The aim of this narrative review is to provide an overview of the current state of scientific knowledge regarding the reasons for non-participation of diabetes patients in structured treatment and education programs.MethodsA literature search was carried out in PubMed. Full texts in German or English on the reasons for the non-participation of diabetes patients in structured treatment and education programs up to 2019 were included. Results9 publications with a total of 4516 study participants were included in the analysis. The participation rate varied between 20 and 50 %. Non-participation was associated with male gender, higher age, membership of ethnic minorities, migration, unemployment, lower education and health literacy. A higher HbA1c, more information about structured treatment and education programs and a recommendation by the family physician increased the likelihood of participation. The non-participants could be divided into patients who could not participate due to logistical barriers, medical or financial reasons and patients who did not want to participate due to subjectively low needs of education, negative emotions related to the education or cultural/religious barriers. There are only two German publications addressing this topic. The results are comparable with those from the international literature.ConclusionsThe reasons for non-participation in structured treatment and training programs refer to the importance of a nationwide offer of structured treatment and training programs, the family doctor as a central element in the coordination and education of patients with diabetes mellitus and the creation of digital alternatives and offers. Germany has a weak database so far and further research is needed.Keywordsdiabetes; non-attendance; structured education


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