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The video recording for this presentation is not available, please download the handout for details on this systematic review.


Primary Focus: Health & Wellness

Secondary Focus: General & Professional Issues

Learning Objectives:

At the end of this presentation, participants will:

Objective 1: Define the scope of self-management in relation to diabetes care.

Objective 2: Describe how the prevalence of diabetes and complications from mismanagement impact the United States healthcare system.

Objective 3: Identify 2-3 ways in which occupational therapists can facilitate diabetes self-management in clinical practice to promote health and wellness.


In the United States (U.S.), 29.1 million people have diabetes mellitus (DM) (Centers for Disease Control and Prevention [CDC], 2014) and the cost of diabetes care totaled $245 billion in 2012 in the U.S. (CDC, 2014). DM and its complications can lead to serious health problems, such as heart disease and stroke, and was the 7th leading cause of death in the U.S. in 2010 (CDC, 2014). The high prevalence of DM and its costs within the U.S. indicate a need to improve diabetes self-management (DSM).

Occupational therapists (OTs) have extensive knowledge on the impact of lifestyle on disease course and overall health (American Occupational Therapy Association [AOTA], 2014). As such, OTs are well positioned to provide DSM interventions (AOTA, 2014). The purpose of this session is to determine how OT interventions can impact patient participation in DSM.

A systematic review of the literature was conducted to examine current research regarding patient participation in DSM. PubMed, Ovid Medline, CINAHL, and the Cochrane Library of Clinical Trials were searched using key terms selected to identify appropriate research studies. The initial search produced 218 articles. After excluding articles and screening for eligibility, 17 articles were critiqued and analyzed for information the scope of OT practice in DSM.

The systematic review revealed the following themes: (1) Empowerment and Self-Efficacy, (2) Psychosocial Factors, (3) Occupational Engagement, and (4) Individualized Care. All of the themes had moderate levels of evidence to support them.

The themes suggest that practitioners should use individualized interventions that focus on empowerment to promote DSM. As OTs are trained in these themes, the profession needs to advocate for the role of OTs in DSM. One reason why OTs are not more involved in DSM may be a lack of training on the procedural aspects of DM medication management. Within OT education, there needs to be increased focus on the scope DSM so OT students are better prepared to provide care to this population. Additionally, the review found no high level evidence where OTs provided the intervention. This evidence is needed in order for practitioners to better understand the impact of OT for individuals with DM.

This session will define the prevalence and impact of DM in the U.S. and describe self-management in DM care. OT’s role in facilitating DSM in clinical practice to promote health and wellness will also be identified.


American Occupational Therapy Association [AOTA]. (2014). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 68(Suppl. 1), S1–S48. doi:10.5014/ajot.2014.682006

Centers for Disease Control and Prevention [CDC]. (2014). National diabetes statistics report, 2014 (Statistics Report). Atlanta, GA: National Center for Chronic Disease Prevention and Health Promotion.

Centers for Disease Control and Prevention [CDC]. (2012). Diabetes report card 2012. Atlanta, GA: Author. Retrieved from card.pdf

Level of Material Being Presented: Introductory

Target Audience: OT, OTA, Members of General Community, Health Professionals

Presentation: 39:44