Abstract
BackgroundShort messages service (SMS) provides a practical medium for delivering content to address patients to adherence to self-management. The aim of study was to design some patient-centered health education messages, evaluate the feasibility of messages, and explore the effect of this model.MethodsThe messages were designed by a panel of experts, and SMS Quality Evaluation Questionnaire was used to evaluate their quality. A two-arm randomized controlled trial was conducted to evaluate the effectiveness of this management model. Participants were randomly divided into an intervention group (IG) who received evaluated messages and a control group (CG) who received regular education. The primary outcomes were changes in plasma glucose and control rates, and the secondary outcomes were improvements in diet control, physical activities, weight control, etc.ResultsA total of 42 messages covering five main domains: health awareness, diet control, physical activities, living habits and weight control were designed, and the average scores of the messages were 8.0 (SD 0.7), 8.5 (SD 0.6), 7.9 (SD 1.0), 8.0 (SD 0.7), and 8.4 (SD 0.9), respectively. In the SMS intervention, 171 patients with an average age of 55.1 years were involved, including 86 in the CG and 85 in the IG. At 12 months, compared with the control group (CG), the decrease of fasting plasma glucose (FPG) (1.5 vs. 0.4, P = 0.011) and control rate (49.4% vs. 33.3%, P = 0.034), the postprandial glucose (PPG) (5.8 vs. 4.2, P = 0.009) and control rate (57.8% vs. 33.7%, P = 0.002) were better in the intervention group (IG). In terms of self-management, improvements in weight control (49.3% vs. 28.2%, P = 0.031), vegetables consumption (87.3% vs. 29.0%, P < 0.001), fruits consumption (27.5% vs. 7.4%, P = 0.022), and physical activities (84.7% vs. 70.0%, P = 0.036) were better in the IG than in the CG.ConclusionsThe overall quality of the messages was high. It was effective and feasible to carry out an SMS intervention to improve the behavioral habits of patients with chronic diseases in remote and undeveloped areas.Trial registrationClinicaltrials.gov, ChiCTR1900023445. Registered May 28, 2019--Retrospectively registered.
Highlights
Short messages service (SMS) provides a practical medium for delivering content to address patients to adherence to self-management
Patient population Patients with Type 2 diabetes mellitus (T2DM) were all admitted to the Department of Endocrinology at the Affiliated Hospital of Inner Mongolia Medical University from October 2016 to March 2017 were selected for participation in the study
In terms of health awareness, we considered that participants need to have a full understanding of the etiology, process, and complications of diabetes, which is beneficial to the plasma glucose control
Summary
According to a report on the global medical expenses of patients with diabetes, China ranks second with $110 billion in 2017 [5]. Faced with such a huge expenditure, the level of glycemic control in China does not inspire optimism, only 32.6% of adult’s plasma glucose levels have been controlled [5]. Interventions through application (APP) and short message service (SMS) of mobile phones are common methods. The SMS, it is a feature of all mobile phones that receive information have the advantages of economical, convenient, real-time, and easy operation [12].
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