The evaluation utilizes a within-subjects design to evaluate: glycaemic control (HbA1c), cholesterol, depression, self-efficacy, health-related quality of life and illness perceptions before and after therapy.

The aim is to test a psychosocial intervention (‘concordance therapy’) for people aged 65 or over with a diagnosis of type 2 diabetes. ‘Concordance therapy’ draws on both cognitive-behavioural therapy and motivational interviewing (see Higgins et al., 2005). The therapy focuses on a specific area of behavioural change (ie. concordance behaviour) and takes the patient through a structured program, first identifying the patient’s perceptions of their condition and attitudes towards self-management, then highlighting and addressing maladaptive cognitions in order to align patient conceptualisations with medical models of disease management. Improving patient self-efficacy is an important goal alongside improving adherence. Concordance therapy was originally developed for treatment of older people with depression and has been demonstrated to improve health outcomes (Higgins et al., 2005). We anticipate that this brief, inexpensive intervention could improve concordance with diet and lifestyle changes in diabetes patients, thus further reducing the risk of diabetic complications such as blindness, renal failure, loss of limbs, heart disease and stroke (DOH, 2001; ONS, 2003) and reducing costs to the NHS. If intervention effects are supported, a manual will be produced so that concordance therapy can be implemented across a range of NHS settings.

Start date: 07/01/2008 End date: 06/12/2009

Funder: NIHR Research for Patient Benefit

Funding: £23,146

Publication: A concordance therapy to help older people self-manage type 2 diabetes