Chronic Disease Management Program Research Articles

Correlation between chronic disease management program (prolanis) activities and health status of hypertension patients at Muara Satu community health center, Lhokseumawe city

The Chronic Disease Management Program (Prolanis) is a program intended for people with chronic diseases such as hypertension which is quite effective but there are still many hypertensive patients who have not used the program. Hypertension is one of the causes of premature death due to the high rate of complications, the incidence of hypertension in the world continues to increase, especially in Indonesia. An increase in the incidence of hypertension will determine a person's health status. The purpose of this study was to identify the Chronic Disease Management Program (Prolanis), to identify the health status of Prolanis participants with hypertension, and to determine the relationship between Prolanis activities and the health status of hypertensive patients at the Muara Satu Subdistrict Health Center, Lhokseumawe City. The research method used a cross sectional research design, to analyze the relationship between Prolanis and the health status of hypertensive patients using the Chi Square test. The results showed the characteristics of the majority of Prolanis participants with hypertension were early elderly (46-55 years), female gender, not working, elementary school education, and marital status, as well as long suffering from hypertension with short duration occupying the highest position. The description of the degree of hypertension is more in the category of first-degree hypertension, most of the elderly who participate in Prolanis are in the good category (65.7%) and have the most health status in the good category (74.3%). The elderly who participate in Prolanis in the sufficient category will have sufficient health status (100%). Likewise, the elderly who participate in Prolanis in the good category will have a good health status (88.5). The conclusion of this study shows that there is a significant relationship between participating in Prolanis activities and the health status of the elderly.

Health Examination of Hypertension and Diabetes Mellitus Patients in the Chronic Disease Management Program in the Community Health Center Waru Pemekasan Working Area

Efforts to prevent and control non-communicable diseases need to be a common concern. One of the efforts made by BPJS in collaboration with existing primary services including community health centers is the chronic disease management program or PROLANIS. Most of the people who come for health checks are the elderly and elderly. To check BMI, especially height in the elderly, it is necessary to check height according to the condition of the elderly. Around 70% of people who come have previously been diagnosed with hypertension. After checking their blood pressure, some of them had their blood pressure controlled. However, this condition needs to be maintained and even improved so that those who experience hypertension can control their condition and prevent them from experiencing further complications. Likewise with those who experience DM, around 73%, but there are still some (9%) who have random high blood sugar levels. By carrying out community service with the topic of health examinations for hypertension and diabetes mellitus patients in the chronic disease management program in the Community Health Center Waru Pemekasan Work Area, it can be beneficial for all patients. The community service activities went well with assistance from the community health center. Of all those who came, around 70% had previously been diagnosed with hypertension and 73% had been diagnosed with DM. From the results of the examination, it was found that some of the hypertension sufferers had a condition where their blood pressure was controlled. Likewise with DM sufferers, some have normal blood sugar.

Using the Theoretical Framework of Acceptability in Assessing Chronic Disease Management Programs

The problem of the increasing incidence of chronic diseases in Indonesia has encouraged the development of the Chronic Disease Management Program. However, in Jambi City, the implementation of various Prolanis initiatives has not been optimal, and community participation in the program is still low. The aim of this research is to describe the public's assessment of Prolanis using the theoretical framework of acceptability. This research is quantitative research with a descriptive approach. 180 respondents were selected using purposive sampling technique. Data analysis uses computerized descriptive statistical analysis. The research results showed that only 50.6% of respondents received Prolanis. The variable with the highest frequency is cost (97.8%). Meanwhile, the variable with the lowest frequency is burden (51.7%). As a recommendation, it is suggested to the government and BPJS Health to increase public understanding of the importance of using Prolanis in an effort to reduce the number of chronic diseases in Jambi City

101 An audit of falls risk assessment in older adults in an Irish general practice

Abstract Background Falls in older adults are common; 30% of over 65 s fall at least once a year, increasing to 50% in the over 80s. Falls are associated with significant morbidity and mortality. By 2020 the national economic burden of falls related injury is expected to exceed €2 billion. International guidance recommends annual screening for falls risk in older adults. The Chronic Disease Management programme (CDM) was introduced into Irish General Practice in 2020, but does not include falls risk assessment. The aim of our audit was to evaluate whether GPs are following international guidelines by routinely assessing falls risk in older adults. Methods A full audit cycle was completed in a large Irish general practice with a mixed population. Cycle 1: October 2022. Cycle 2: April 2023. Audit Standard: Opportunistic case finding as per the September 2022 World Guidelines for Falls Prevention and Management in Older Adults: A Global Initiative. Criteria: All patients 65 years of age and older should be asked 3 Key Questions (3KQ): (1) Any falls in the last year? (2) Any unsteadiness when standing or walking? (3) Any fear of falling? All patients meeting referral criteria should be referred. Falls prevention advice should be given routinely. Inclusion criteria: Patients aged 65 years and over attending for routine CDM GP review. Intervention: Practice education session, falls algorithm in every room, consensus meeting. Results Cycle 1, 34 patients: (a) 3KQ 0% (b) appropriate referrals 75% (c) falls risk advice 9%; Cycle 2, 32 patients: (a) 3KQ 50% (b) appropriate referrals 89% (c) falls risk advice 22%. Conclusion This audit shows that a targeted falls risk assessment, completed as part of the CDM reviews, leads to a significant improvement in adherence to international falls guidelines. We suggest that this is a feasible intervention, and recommend the incorporation of a falls risk assessment in the chronic disease management template.

ISOMETRIC EXERCISES AND MASSAGE FOR HYPERTENSIVE PATIENTS AT PROLANIS MEMBERS AT JOHAR BARU HEALTH CENTER, JAKARTA

Hypertension is a global health problem and is recognized as a major contributor to the burden of cardiovascular disease. The prevalence of hypertension continues to increase due to lifestyle changes such as smoking, obesity and psychosocial stress. It is important to educate people with hypertension to self-manage themselves at home. This community service activity aimed to provide health information about hypertension and self-management in the form of exercise and massage. This activity was attended by 30 Prolanis (Chronic Disease Management Program) participants at Johar Baru Health Center in Jakarta. There were 5 sessions in this activity: Session 1&2 for registration and measurement of physiological parameters, followed by cardiovascular exercises. Session 3 for health education about hypertension in general, then followed by next session on isometric exercises with a tennis ball and final session on of self-massage exercise. The evaluation done on this activity showed that the participants demonstrated isometric exercises and back massage techniques that can be carried out independently. Hypertensive patients are expected to be actively involved in Prolanis activities and conduct self-management intervention to maintain their blood pressure and prevent the complications.

OPTIMALISASI TELEMEDICINE OLEH TENAGA KESEHATAN DI FASILITAS PELAYANAN KESEHATAN PRIMER

The lack of health communication technology literacy in the elderly group affects the high mortality rate due to non-communicable diseases. Health communication and information technology media can be a medium for health workers and elderly participants such as telemedicine but there are still limitations in device use. This activity aimed to educate and socialize the concept of telemedicine applications to health workers and participants able to be independent in facilitating the community regarding health issues, especially the risk of Hypertension and Diabetes Mellitus. The implementation focused on empowering participants in the Elderly Chronic Disease Management Program and health workers in Primary Health Care Facilities in Semarang Regency with sub-activities of Communication Techniques Training and Socialization of Prolanis Telemedicine Applications to Health Workers and Elderly Participants. The results of the service show that health workers who are responsible for Prolanis activities understand the importance of communication with participants through health digitization and data recording for participants through health technology media. Participants found this application useful for communication systems and data collection, and hope it will be further developed and re-socialized.

PROLANIS PARTICIPANTS ACTIVITY TO CONTROL REFERRAL TO ADVANCED HEALTH FACILITIES

The Chronic Disease Management Program (Prolanis) is a program that synergizes the involvement of participants, health facilities, and Healthcare and Social Security Agency (BPJS Kesehatan). Health Center has not been effective in treating Non-Communicable Diseases (NCDs). This requires special efforts to prevent and control NCDs so as not to burden national health insurance program. The purpose of this study was to find out the impact of prolanis on referral control and efficiency chronic disease services. Exploratory research design was used to determine the application of prolanis policy.The population is Prolanis participants who were held at the Bengkulu City Health Center. The sample was obtained by convinence sampling with 211 subjects participated in Prolanis activities. The selected sample was prolanis participants who suffered from diabetes mellitus and hypertension. Based on correlation and regression tests, healthy living adherence with patient referral frequency indicated a weak relationship (r=0.155) and positive pattern. It means the higher compliance of participants, the lower referral frequency. The result showed that there was relationship between the compliance of healthy living participants with patient referrals in Bengkulu City (p=0.024). This means that there is significant difference between FKTL referrals before and after the participation of prolanis in Bengkulu City. Active prolanis participants can encourage participants with chronic diseases to achieve quality of life and reduce frequency of referral to FKTL. Reducing the frequency of referral FKTL can streamline the cost of health services to FKTL.

Analysis of The Effect of Chronic Disease Management Program (Prolanis) on Patient Satisfaction Level for Hypertensive Patients at Baros Health Center and Rangkasbitung Health Center in Lebak Regency, Banten Province

In order to overcome hypertension which has become a serious public health problem, the Government through BPJS Health is taking a proactive approach. One of them is by involving first-level health facilities (FKTP), especially Health centers, to carry out promotive and preventive efforts known as the Chronic Disease Management Program (Prolanis). Prolanis' goal is to encourage people with chronic diseases, for example, hypertension, to achieve an optimal quality of life so as to prevent complications.
 This study aims to find out that the implementation of Prolanis can indeed increase patient satisfaction with mild and moderate hypertension at the Health center so that it is feasible to be funded by BPJS Health by knowing the characteristics and satisfaction of hypertensive patients at two Puskesmas, namely the Baros Health Center which has implemented Prolanis and the Rangkasbitung Health Center which has not implemented Prolanis. Data were obtained through questionnaires distributed to hypertensive patients in two health centers, namely the Baros Health Center and Rangkasbitung Health Center. The independent variables used in the study are patient characteristics Meanwhile, the dependent variable is patient satisfaction. Data were analyzed by means of different test analyses using SPSS version 23.0.
 The results showed that the characteristics of the patients were different for the Baros Health Center and Rangkasbitung Health Center. Judging from satisfaction based on its characteristics, age has different satisfaction both at the Baros Health Center and at the Rangkasbitung Health Center. Judging from the patient's satisfaction related to knowledge and also Prolanis services in general for the Baros Health Center area it is higher (satisfied) and similarly, the blood pressure is more controlled compared to the Rangkasbitung Health Center.

The Impact of Telenursing on Self-Care Management and Quality of Life for Chronic Disease Management Program (PROLANIS) Members with Type 2 Diabetes Mellitus at the Garuda Health Center in Bandung City, Indonesia, in 2022

Diabetes Mellitus (DM) type 2 is rapidly becoming one of the world's most common non-communicable diseases (NCDs), and one of the most frightening problems in public health. Patients with type 2 diabetes mellitus must be able to manage their disease independently to control blood glucose and prevent complications. Community empowerment and social engineering can be done by nurses through remote communication with patients via telenursing. Identifying the Effect of Telenursing on Self-Care Management and Quality of Life for Members of the Chronic Disease Management Program (PROLANIS) with Type 2 Diabetes Mellitus. Using the pre-experiment design method with one group pretest-posttest design. The research sample consisted of 45 respondents, 15 male respondents and 30 female respondents, taking the sample using accidental sampling. Data collection using the Summary of Diabetes Self Care Activities (SDSCA) and Diabetes Quality of Life (DQOL) instruments the test used is the Wilcoxon Signed Ranks Test. All manuscripts must contain an abstract, which summarizes the purposes of the work, the methods, the most significant results, and the conclusions. Based on the results of the Wilcoxon test, with a 95% confidence level p-value (0.001). There is an effect of telenursing therapy on improving the quality of life of PROLANIS members with type 2 diabetes mellitus. It is hoped that respondents and elders can improve self-care management and quality of life through the stages of Diabetes Self-Management Education (DSME), which can be carried out daily under health workers’ guidance through telenursing or family.

The Relationship Of Family Duty Implementation With DM Patient's Compliance In Prolanis Activities In The Work Area Of Bojonegoro Public Health Center

The Chronic Disease Management Program (Prolanis) is a health service with a proactive approach that is carried out in an integrated manner for people with diabetes mellitus and hypertension. The aim of the study was to determine the relationship between the implementation of family tasks and the compliance of Diabetes Mellitus patients in Prolanis activities. Design of analytic research with cross sectional approach. The population of prolanis DM participants was 84 people with simple random sampling with a sample of 69 respondents. Variable Independent implementation of family tasks and dependent DM patient compliance. Data processing begins with editing, coding, scoring, tabulating, and is analyzed using the Chi Square test and Coefficient Contingency, which are presented in tabular and narrative form. The results of the study were all 11 respondents (100.0%) who carried out family duties well, were obedient to Prolanis activities. Chi Square test results obtained P value = 0.010 < (0.05), so H0 was rejected, then H1 was accepted with a Coefficient Contingency value of 0.342. The conclusion is that there is a relationship between the implementation of family tasks and adherence of DM patients in Prolanis activities. Families must increase support, remind the schedule of Prolanis activities, pick up and drop off and increase access to participate in Prolanis activities.

Individual Determinant Factors of Patients with Hypertension and the Utilization of Chronic Disease Management Program (Prolanis) Services in First-Level Healthcare Facilities in Pesawaran District, Lampung, Indonesia

Hypertension is estimated to affect 1.28 billion adults aged 30-79 years worldwide. One of the efforts to treat hypertension at first-level healthcare facilities (FKTP) by BPJS Health is the chronic disease management program (Prolanis). Many factors influence the utilization of first-level health services. This study aimed to analyze the relationship between individual determinant factors and the use of Prolanis services at FKTP Pesawaran Regency, Lampung, Indonesia. This cross-sectional study was conducted on 330 patients with hypertension in four FKTPs, with the most participants holding Prolanis activities in the Pesawaran district, Lampung province, Indonesia, from February to April 2023. The chi-square test and logistic regression were used for data analysis. The results showed that there was a relationship between attitude (p-value<0.001), knowledge (p-value<0.001), access (p-value=0.010), level of hypertension (p-value<0.001), and utilization of Prolanis services at FKTP Pesawaran Regency. This study concludes that the individual determinants of hypertension sufferers have a significant relationship with the utilization of Prolanis in the FKTP of Pesawaran Regency, Lampung, Indonesia. It is recommended that patients with hypertension can make better use of Prolanis to maintain their health and prevent further complications.

The Functional and Psychosocial Consequences of COPD.

COPD is a chronic respiratory disease that commonly coexists with other chronic conditions. These comorbidities have been shown to influence overall disease burden and mortality in COPD, and these comorbidities have an important impact on functional status and other psychosocial factors. Mental health disorders, especially anxiety and depression are common comorbidities in COPD. However, the mechanisms and interactions of anxiety and depression in COPD are poorly understood and these conditions are often underdiagnosed. The interplay between anxiety and depression and COPD is likely multifactorial and complex. An obvious mechanism is the expected psychological consequences of having a chronic illness. However, there is increasing interest in other potential biological processes, such as systemic inflammation, smoking, hypoxia, and oxidative stress. Recognition and diagnosis of comorbid anxiety and depression in patients with COPD is often challenging because there is no consensus on the appropriate screening tools or rating scales to use in this patient population. Despite the challenges in accurate assessment of anxiety and depression, there is growing evidence to support that these comorbid mental health conditions in COPD result in worse outcomes, including poor health-related quality of life, increased exacerbations with associated health-care utilization and cost, increased functional disability, and increased mortality. There are limited data of variable quality on effective treatment and management strategies, both pharmacologic and non-pharmacologic, for anxiety and depression in COPD. However, cumulative evidence demonstrates that complex psychological and lifestyle interventions, which include a pulmonary rehabilitation component, may offer the greatest benefit. The high prevalence and negative impact of depression and anxiety highlights the need for comprehensive, innovative, and standardized chronic disease management programs for individuals with COPD.

Development, successes, and potential pitfalls of multidisciplinary chronic disease management clinics in a family health team: a qualitative study

BackgroundThe creation of Family Health Teams in Ontario was intended to reconfigure primary care services to better meet the needs of an aging population, an increasing proportion of which is affected by frailty and multimorbidity. However, evaluations of family health teams have yielded mixed results.MethodsWe conducted interviews with 22 health professionals affiliated or working with a well-established family health team in Southwest Ontario to understand how it approached the development of interprofessional chronic disease management programs, including successes and areas for improvement.ResultsQualitative analysis of the transcripts identified two primary themes: [1] Interprofessional team building and [2] Inadvertent creation of silos. Within the first theme, two subthemes were identified: (a) collegial learning and (b) informal and electronic communication.ConclusionEmphasis on collegiality among professionals, rather than on more traditional hierarchical relationships and common workspaces, created opportunities for better informal communication and shared learning and hence better care for patients. However, formal communication and process structures are required to optimize the deployment, engagement, and professional development of clinical resources to better support chronic disease management and to avoid internal care fragmentation for more complex patients with clustered chronic conditions.

Interventions to Improve Surveillance for Hepatocellular Carcinoma in High-Risk Patients: A Scoping Review.

Hepatocellular carcinoma (HCC) is most often a sequela of chronic liver disease or chronic hepatitis B infection. Among high-risk patients, surveillance for HCC every 6months is recommended by international guidelines. However, rates of HCC surveillance are suboptimal (11-64%). Barriers at the patient, provider, and healthcare delivery system levels have been identified. We performed a systemic scoping review to identify and characterize interventions to improve HCC surveillance that has previously been evaluated. Searches using key terms in PubMed and Embase were performed to identify studies examining interventions designed to improve the surveillance rate for HCC in patients with cirrhosis or chronic liver disease that were published in English between January 1990 and September 2021. Included studies (14) had the following study designs: (1) randomized clinical trials (3, 21.4%), (2) quasi-experimental (2, 14.3%), (3) prospective cohort (6, 42.8%), and (4) retrospective cohort (3, 21.4%). Interventions included mailed outreach invitations, nursing outreach, patient education with or without printed materials, provider education, patient navigation, chronic disease management programs, nursing-led protocols for image ordering, automated reminders to physicians and nurses, web-based clinical management tools, HCC surveillance databases, provider compliance reports, radiology-led surveillance programs, subsidized HCC surveillance, and the use of oral medications. It was found that HCC surveillance rates increased after intervention implementation in all studies. Despite improvements in HCC surveillance rates with intervention, compliance remained suboptimal. Further analysis of which interventions yield the greatest increases in HCC surveillance, design of multi-pronged strategies, and improved implementation are needed.

Relationship between family history, diet and sedentary behavior with the incidence of diabetes mellitus

Diabetes Mellitus (DM) is a degenerative disease that is a public health problem throughout the world. Diabetes mellitus has become one of four non-communicable diseases that will cause around 6.7 million people to die in 2021. Currently, the number of cases and prevalence of diabetes mellitus continues to increase. There are several risk factors that can cause diabetes mellitus, including family history, food patterns and sedentary behavior. This study aims to determine the relationship between family history, diet and sedentary behavior on the incidence of diabetes mellitus. The population in this study were all patients aged 45- 75 years who were treated at the Chronic Disease Management Program (Prolanis), Public Health Rebo District Market Center. Samples were taken as many as 68 respondents with a purposive sampling technique. The data was collected using a questionnaire and then analyzed using the chi square test. The results showed that there is a relationship between family history (p-values = 0.003 with OR = 5.061), diet (p-values = 0.002 with OR = 5.667) and sedentary behavior (p-values = 0.011). with OR value = 3829) with the incidence of diabetes mellitus Keywords: Family History, Food Patterns, Sedentary Behavior, Diabetes Mellitus, Incidence

Patient engagement in interprofessional team-based chronic disease management: A qualitative description of a Canadian program

ObjectiveTo explore how patients with chronic obstructive pulmonary disease (COPD) perceive their engagement and roles within an interdisciplinary team-based care model. MethodsA single intrinsic case study was used. Focus group participants were recruited from the Best Care COPD program across nine sites. Transcripts from patient focus groups were supplemented by healthcare provider focus group transcripts and thematically analysed. ResultsThe majority of patients viewed themselves as having an inherent or central role on the team, which was corroborated by healthcare providers. Both positive (e.g., a desire to learn) and negative drivers (e.g., fear of inadequate care without self-advocacy) of active engagement were identified, for which patient-led communication was key. Components of the interdisciplinary team-based care model, including provider coordination and action planning, enabled positively driven active engagement and increased self-management. ConclusionAlthough patients had heterogenous perspectives about engagement, most patients viewed themselves as, and were satisfied with, having a central role in their care. Active and passive engagement preferences were influenced by personal motivations and past experiences, amongst other factors. Practice ImplicationsThis study demonstrates how interdisciplinary chronic disease management programs can support patient engagement. Clarity of provider expectations, and communication about patients’ roles and preferences, are recommended.

Cognitive function level and chronic disease incidence rate by age of older adults living in the community

AbstractBackgroundResearch has shown that decline in cognitive function is related to the level of chronic disease in old age. Most studies, however, have either examined limited aspects of cognitive function or used assessment tools with low accuracy. A limited range of cognitive function items and low‐accuracy cognitive function assessment tools may bias the findings. Current literature also has paid little attention to the age‐gradient association between cognitive function and chronic diseases. Utilizing a new cognitive classification method, this study investigated cognitive function‐associated chronic diseases and their relationship with age. Empirical knowledge about the dynamic among cognitive function, changes in chronic diseases, and age may contribute to establishing comprehensive prevention and management programs of diseases in later years.MethodA total of 6,940 people aged between 55 to 105 years from the 2018 Korean Longitudinal Study of Aging panel data were included in this study. According to the Korean Mini‐Mental State Examination’s total score and instrumental activities of daily living assistance, cognitive status was classified into normal cognition, moderate cognitive impairment, and severe cognitive impairment. The Poisson regression analysis was used to calculate the incident rate ratios (IRR) of cognitive status by age and the incidence of chronic diseases.ResultThe incidence rate of chronic diseases was 1.07 times higher in the moderate cognitive impairment group (n = 4665) than in the normal cognitive group (n = 4665). In addition, it was 1.24 times higher in the severe cognitive impairment group (n = 420) than in the normal cognitive group (Table 1) and the incidence of chronic diseases according to cognitive function increased with age (figure 1).ConclusionApplying the new cognitive function classification, we found the incidence rate of age‐related chronic diseases increased with the cognitive status, indicating incidence of chronic diseases increases as the cognitive state decreases and the age increases, leading to complex chronic conditions. This finding points to the importance of an integrated program of cognitive decline prevention and the chronic disease management program, which are currently developed and implanted separately.

Influence of cognitive function and social support on health-related quality of life of elderly men in partial medically underserved rural areas: A cross-sectional study

Purpose: This study aimed to identify factors influencing the health-related quality of life of elderly men in partial medically underserved rural areas. Methods: The subjects included 182 elderly men aged 65 or older living in the jurisdictions of the Health Care Centers in G, I, and J Myeon, which were medically underserved rural areas in Gongju City, South Korea. Data were collected on October 31 to November 1, 2020, and were analyzed with descriptive statistics, t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical linear regression. Results: The subjects’ scored mean 24.20±3.29 points out of 30 in cognitive functions and mean 17.08±9.40 out of 60 in social support. The influential factors included three chronic diseases (β=-.50, p<.001), two chronic diseases (β=-.30, p<.001), one chronic disease (β=-.21, p<.001); fair subjective health status (β=.24, p<.001); good subjective health status (β=.25, p<.001); cognitive functions (β=.17, p=.004); aged 80 or older (β=-.16, p=.006); and brushing teeth three times per day or more (β=.14, p=.009) with an explanatory power of 53.8%. Conclusion: It is necessary to develop chronic disease management and cognitive function enhancement programs to identify factors influencing the health-related quality of life of elderly men in partial medically underserved rural areas and thus improve their health-related quality of life.

Exploratory Study for the Development of a Chronic Disease Management Program for Patients Registered in One of the Korean Seon Centers

Exploratory Study for the Development of a Chronic Disease Management Program for Patients Registered in One of the Korean Seon Centers

Analysis of PROLANIS activities on controlling type-2 diabetes mellitus at Puskesmas Tulungagung in 2022

Background. Non-communicable diseases are still a global and national problem. Around 71% of deaths worldwide are caused by non-communicable diseases, and about 36 million people per year died from them in 2016. One of these preventions is the prevention of type-2 diabetes mellitus (type-2 DM), which can be done by knowing the risk factors. There are two risk factors for type-2 DM: the ones we can change and the ones we cannot change. We can change our lifestyle, such as what food we consume, rest patterns, physical activity, and stress management. In contrast, we cannot change age and genetics. Objective. This research aimed to analyze PROLANIS activities on controlling type-2 diabetes mellitus. Methods. This research is a cross-sectional study carried out at selected Puskesmas (Community Health Center) in Tulungagung Regency between April and July 2022. The selection of research locations was based on the area’s characteristics in Tulungagung Regency, namely urban Puskesmas, rural Puskesmas, and mountainous Puskesmas. One Puskesmas represented each region. Results. Based on data from the Health Department of Tulungagung, with the results of 546 type-2 DM patients, only 34% participated in the PROLANIS (chronic disease management program) activities. Of those who participated in PROLANIS, 36% could control their type-2 DM, which means there were still many type-2 DMs that had not been controlled. Conclusion. There was a relationship between attendance in PROLANIS activities and controlled blood sugar levels in patients with type-2 DM.