684-P: Assessment of Individual Self-Management Using the Novel LMC Skills, Confidence, and Preparedness Index (SCPI)

• Published in: Diabetes (New York, N.Y.) Vol. 68; no. Supplement_1
• Main Authors: ARONSON, RONNIE, LI, AIHUA, BROWN, RUTH E., ORZECH, NAOMI, LYONS, ASHLEY, WALKER, ASHLEIGH
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 01.06.2019
• Subjects: Education; Glucose monitoring
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db19-684-P

Objective: The SCPI was developed to assess knowledge, confidence and preparedness, for the AADE7 Self-Care Behaviours™, in a clinically meaningful, easy to use measure; with immediate feedback to the healthcare providers (HCP). This final version, an electronic 23-item, 7-point Likert questionnaire, was evaluated for validity, reliability (Part 1) and responsiveness to an intervention (Part 2). Methods and Results: Part 1: 405 participants (200 T1D and 205 T2D; duration 15 ± 12 years (mean ± SD); A1C 7.7 ± 1.3%) completed the SCPI (completion time 4.9 ± 4.3 minutes). Internal consistency was high: intraclass correlation (ICC) was 0.93 overall (p<0.01) with a range of 0.84 to 0.88 for each subscale of Skill, Confidence and Preparedness. There was good external validity in correlation with A1C for the total score (T1D r=-0.26; T2D r=-0.20) (p<0.001) and for each of the subscales. Demographic variables (age, sex, education, ethnicity and income) were not associated. Test-retest reliability after a 1-week interval was high (r=0.79, P<0.001). Part 2: 51 subjects with A1C > 8.0% (17 T1D and 34 T2D; duration 15 ± 11 years; A1C 9.3 ± 1.0%) were enrolled in a comprehensive education program (6 visits over 4 months) targeting areas identified by the SCPI as needing improvement. At completion, mean A1C had improved by 1.2 ± 0.2% (mean ± SE, p<0.001). Total SCPI score and each of the three subscores similarly increased significantly compared to baseline (p<0.01). Among ‘education responders’ (A1C improvement >0.5% with no therapy change), A1C improvement was correlated with the change in total SCPI scores (r=-0.3, p=0.17). Conclusions: The SCPI is a highly valid and reliable, easy to use, electronic tool with immediate guidance to the HCP. In general populations with both T1D and T2D, SCPI scoring correlates with glycemic control and is unaffected by unrelated demographic factors. It is effective as a guide to educational intervention and patient gains correlate with SCPI score improvement. Disclosure R. Aronson: Research Support; Self; AstraZeneca, Becton, Dickinson and Company, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Medtronic, Merck & Co., Inc., Novo Nordisk Inc., Sanofi, Senseonics. A. Li: None. R.E. Brown: None. N. Orzech: None. A. Lyons: Consultant; Self; Novo Nordisk Inc. A. Walker: Other Relationship; Self; Medtronic.