Effect of patient motivation model on blood glucose management in patients with type 2 diabetes mellitus in community

Abstract

Objective To investigate the effect of patient motivation model on blood glucose and quality of life in community type 2 diabetes mellitus (T2DM) patients. Methods The study recruited 258 eligible adult patients who were residents with health records from Waigang community health centers of Shanghai Jiading District. The subjects were randomly divided into incentive group (n=123) and control group(n=135). We established a cooperative pathway between community health care centers and general hospital, trained community health workers, equipped with the necessary clinical drugs, and finally, the Advance System for Diabetes Management was used to carry out the tele-medicine. The type 2 diabetic patients, who were set goals in blood glucose, managed by the general practitioners, the daily health behaviors of the patients were regulated. The study group received the incentives if they can obtain or/and maintain the ideal level of HbA1C during the 1-year study period. The control group would not receive any incentives but would be provided with diabetes education booklet and to follow group educational courses for diabetes mellitus control as usual. Results After 12 months, there were significant differences in HbA1C, fasting blood glucose, and the on-target rate of HbA1C in both two groups as compared with the baseline levels(P<0.05). In the investigation of quality of life(QOL), we found significant differences in the scores of total QOL, the degree of satisfaction, and the degree of influence between the incentive group and the control group one year after intervention(P<0.05). Conclusion The objective motivation model seems to exert a positive effect on blood glucose control and self-management for those with T2DM. Key words: Diabetes mellitus, type 2; Patient motivation model; Blood glucose; Quality of life; Self-management