scholarly journals Comparative Effectiveness and Maintenance of Diabetes Self-Management Education Interventions for Marshallese Patients With Type 2 Diabetes: A Randomized Controlled Trial

Diabetes Care ◽  
2019 ◽  
Vol 42 (5) ◽  
pp. 849-858 ◽  
Author(s):  
Pearl A. McElfish ◽  
Christopher R. Long ◽  
Peter O. Kohler ◽  
Karen H.K. Yeary ◽  
Zoran Bursac ◽  
...  
2020 ◽  
Author(s):  
Roy Sabo ◽  
Jo Robins ◽  
Stacy Lutz ◽  
Paulette Kashiri ◽  
Teresa Day ◽  
...  

UNSTRUCTURED Aims: To help patients with type 2 diabetes receive recommended self-management education and support (DSMES), we designed the Diabetes Engagement and Activation Platform (DEAP) – an automated patient education tool integrated into primary care workflow – and examined its implementation and effectiveness. Methods: We invited patients age 18-85 years with hemoglobin A1C (HbA1c) ≥ 8 to participate in a randomized controlled trial comparing DEAP to usual care. DEAP modules addressing DSMES domains were programmed into patient portals, each with self-guided educational readings, videos and questions. Care teams received patient summaries and were alerted to patients with low confidence or requesting additional help. HbA1c, body mass index (BMI), and blood pressure were measured. Results: Implementation: Out of the 680 patients invited to participate 337 (49%) agreed and were randomized. Of 189 intervention patients, all accessed the first module and 140 (74%) accessed all nine modules. Post-module knowledge and confidence scores were high. Only 18 patients requested additional help from the care team. Effectiveness: BMI was lower for intervention patients than controls at 3 months (31.7 versus 32.1 km/m2, p=.04) and 6 months (32.5 versus 33.0 km/m2, p=.003); improvements were even greater for intervention patients completing at least one module. There were no differences in 3 or 6 month HbA1c or blood pressure in the intention to treat analysis. However, intervention patients completing at least one module compared to controls had a better HbA1c (7.6% versus 8.2%, p=.03) and DBP (72.3 versus 75.9 mmHg, p-value = .01) at 3 months. Conclusions: A significant proportion of patients will participate in an automated virtual diabetes self-management program embedded into patient portals and system show promise in helping patients manage their diabetes, weight, and blood pressure.


JMIR Diabetes ◽  
10.2196/26621 ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. e26621
Author(s):  
Roy Sabo ◽  
Jo Robins ◽  
Stacy Lutz ◽  
Paulette Kashiri ◽  
Teresa Day ◽  
...  

Background Patients with type 2 diabetes require recommendations for self-management education and support. Objective In this study, we aim to design the Diabetes Engagement and Activation Platform (DEAP)—an automated patient education tool integrated into primary care workflow—and examine its implementation and effectiveness. Methods We invited patients aged 18-85 years with a hemoglobin A1c (HbA1c) level ≥8 to participate in a randomized controlled trial comparing DEAP with usual care. DEAP modules addressing type 2 diabetes self-management education and support domains were programmed into patient portals, each with self-guided educational readings, videos, and questions. Care teams received patient summaries and were alerted to patients with low confidence or requesting additional help. HbA1c, BMI, and systolic and diastolic blood pressure (DBP) were measured. Results Out of the 680 patients invited to participate, 337 (49.5%) agreed and were randomized. All of the 189 intervention patients accessed the first module, and 140 patients (74.1%) accessed all 9 modules. Postmodule knowledge and confidence scores were high. Only 18 patients requested additional help from the care team. BMI was lower for intervention patients than controls at 3 months (31.7 kg/m2 vs 32.1 kg/m2; P=.04) and 6 months (32.5 kg/m2 vs 33.0 kg/m2; P=.003); improvements were even greater for intervention patients completing at least one module. There were no differences in 3- or 6-month HbA1c or blood pressure levels in the intent-to-treat analysis. However, intervention patients completing at least one module compared with controls had a better HbA1c level (7.6% vs 8.2%; P=.03) and DBP (72.3 mm Hg vs 75.9 mm Hg; P=.01) at 3 months. Conclusions The findings of this study concluded that a significant proportion of patients will participate in an automated virtual diabetes self-management program embedded into patient portals and health systems show promise in helping patients manage their diabetes, weight, and blood pressure. Trial Registration ClinicalTrials.gov NCT02957721; https://clinicaltrials.gov/ct2/show/NCT02957721


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Esther du Pon ◽  
Nanne Kleefstra ◽  
Frits Cleveringa ◽  
Ad van Dooren ◽  
Eibert R. Heerdink ◽  
...  

Online care platforms can support patients with type 2 diabetes (T2DM) in managing their health. However, in the use of eHealth, a low participation rate is common. The Proactive Interdisciplinary Self-Management (PRISMA) program, aimed at improving patients’ self-management skills, was expected to encourage patients to manage their disease through the use of an online platform. Therefore, the objective of the current study was to investigate whether a group education program can improve the use of an online care platform in patients with T2DM treated by primary care providers in the Netherlands. In a randomized controlled trial, patients with T2DM received either PRISMA with usual care or usual care only. During a six-month follow-up period in 2014-2015, usage (number of log-ons and time spent per session) of an online care platform (e-Vita) aimed at improving T2DM self-management was assessed. A training about the functionalities of e-Vita was offered. The sample consisted of 203 patients. No differences were found between the intervention and control groups in the number of patients who attended the platform training (interested patients) (X21=0.58; p=0.45), and the number of patients who logged on at least once (platform users) (X21=0.46; p=0.50). In addition, no differences were found between the groups in the type of users—patients who logged on twice or more (active users) or patients who logged on once (nonactive users) (X21=0.56; p=0.45). The PRISMA program did not change platform usage in patients with T2DM. In addition, only a small proportion of the patients logged on twice or more. Patients probably need other encouragements to manage their condition using an online platform.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chontira Riangkam ◽  
Aurawamon Sriyuktasuth ◽  
Kanaungnit Pongthavornkamol ◽  
Worapan Kusakunniran ◽  
Apiradee Sriwijitkamol

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.


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