Abstract
PurposeThis study aimed to examine the effects of a three-month mobile health diabetes self-management program (MHDSMP) on glycemic control, diabetes self-management (DSM) behaviors and patient satisfaction in adults with uncontrolled type 2 diabetes (T2DM) in Thailand.Design/methodology/approachThis was a three-arm, parallel-group, randomized controlled trial among 129 adults with uncontrolled T2DM who attended the medical outpatient department in a medical center. The participants were randomly assigned to the three study groups (n = 43 per group), including MHDSMP, telephone follow-up (TF) and usual care (UC). MHDSMP encompassed four components, including DSM engagement, DSM mobile application, motivational text messages and telephone coaching. Outcomes were evaluated at three-month end-of-study by using HbA1C and response to the Summary of Diabetes Self-Care Activities (SDSCA) and the Client Satisfaction Questionnaire (CSQ-8). Data were analyzed by using descriptive statistics and multivariate analysis of covariance (MANCOVA).FindingsThe findings revealed that at the end-of-study, HbA1C decreased from 7.80 to 7.17% (p < 0.001) in MHDSMP group, from 7.72 to 7.65% (p = 0.468) in TF group, and from 7.89 to 7.72% (p = 0.074) in UC group. Significantly higher SDSCA and CSQ-8 scores were also observed in MHDSMP compared to TF and UC groups (F = 12.283, F = 19.541, F = 8.552, p < 0.001, respectively).Originality/valueThis study demonstrated that MHDSMP adjunct with usual care is beneficial for patient outcomes in adults with uncontrolled T2DM in Thailand, compared to TF and UC groups.
Highlights
Type 2 diabetes (T2DM) is a non-communicable disease which is a serious global public health problem among adults
This study demonstrated that mobile health diabetes self-management program (MHDSMP) adjunct with usual care is beneficial for patient outcomes in adults with uncontrolled T2DM in Thailand, compared to telephone follow-up (TF) and UC groups
Three participants (2.3%) (MHDSMP 5 2, TF 5 1) were removed from the study according to the discontinuation criteria, and four participants (3.1%) (TF 5 1, UC 5 3) were lost to follow-up
Summary
Type 2 diabetes (T2DM) is a non-communicable disease which is a serious global public health problem among adults. Diabetes causes many burdensome complications and is the 7th leading cause of death worldwide [1]. It is anticipated that the global prevalence of diabetes will increase from 425 m people in 2017 to 629 m by 2045. T2DM accounts for approximately 90% of all cases of diabetes. In Thailand, diabetes prevalence is rising in parallel to the global trend. Two-thirds of T2DM cases have uncontrolled diabetes (HbA1C > 7%) [2]. Glycemic control prevents diabetes-related complications and that helps reduce the burden in the healthcare system and healthcare expenditures [1, 3]
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