Aims: The objective of this study was to study the effectiveness of structured care with and without integrated education with regard to patients' knowledge, self-care behaviour and disease perception.
Methods: Four diabetes care programmes implemented in a daily primary care setting were compared, two based on structured care and two on education integrated into structured care. Measurements were taken at baseline and after 6 and 12 months.
Results: The study included 243 patients with Type 2 diabetes mellitus treated by a general practitioner (mean age 64.0 years; diabetes duration 7.1 years). The level of patients' disease knowledge increased in all programmes, was preserved at follow-up and differed between programmes with a specific educational component (37%) on one hand and the non-educational programmes (11%) on the other (P < 0.001). The percentage of patients performing self-care behaviour increased in all programmes, but more so in the programmes with an educational component. In addition, an increase in the frequency of self-care behaviour was observed, whereas no change in disease perception was found. In cross sectional analyses disease knowledge and self-care behaviour were positively related (partial correlation coefficient: 0.35; P < 0.001 adjusted for age, sex, level of education and duration of diabetes).
Conclusions: The results indicate that primary care programmes which integrated education into structured care are able to improve both Type 2 diabetic patients' disease knowledge and their self-care behaviour. These improvements endured after the completion of the programmes, which suggests that they initiate lasting changes in the way patients handle their disease.