Evaluating a Structured Self‐Management Kit for Type 2 Diabetes: A Mixed Methods Service Evaluation in Primary Care
Nitish Nachiappan, David A. Scott, Mark Stone, Nachiappan ChockalingamABSTRACT
Rationale, Aims and Objectives
Type 2 diabetes places increasing pressure on health services, and engagement with structured education and routine preventative care remains variable. Practical self‐management tools may help people translate advice into daily routines. This service evaluation examined the implementation, acceptability and early outcomes of the MyHealthKits Diabetic Wellness Kit in routine primary care.
Method
A prospective convergent mixed methods service evaluation was conducted across 13 general practices within three Primary Care Networks in Staffordshire and Stoke‐on‐Trent. Adults with type 2 diabetes received a Diabetic Wellness Kit containing foot care tools, educational materials and access to online resources. Health‐related quality of life and healthcare use were measured at baseline and after 12 weeks using EQ‐5D‐5L and MODRUM questionnaires. Quantitative data were analysed descriptively, with paired EQ‐5D utility change assessed using a paired t ‐test. Semi‐structured interviews with a purposive sample explored usability and perceived impact and were analysed thematically.
Results
A total of 782 kits were distributed. Of these, 131 participants completed both baseline and follow‐up questionnaires; three were excluded because they reported not receiving the kit, leaving 128 in the primary analysis cohort. Mean EQ‐ 5D utility scores increased from 0.61 to 0.70, with 65% of complete responders reporting improvement. Self‐reported healthcare use was lower across all service categories, with an estimated mean cost difference of £288 per participant. Sensitivity analyses excluding inpatient episodes, and excluding both inpatient episodes and day case appointments, gave estimated mean cost differences of £186 and £183 respectively. Qualitative findings indicated improved self‐efficacy, daily care routines, confidence and independence.
Conclusion
The kit was feasible, acceptable and associated with early improvements in reported wellbeing and self‐management. Findings should be interpreted cautiously because the evaluation had no control group, high attrition, short follow‐up, and self‐reported healthcare use. Further controlled studies with longer follow‐up and verified healthcare use data are needed.