加纳城区 2 型糖尿病管理中手机干预先导试验：一项随机对照试验

Pilot Mobile Phone Intervention in Promoting Type 2 Diabetes Management in an Urban Area in Ghana: A Randomized Controlled Trial.

机构信息

Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

出版信息

Diabetes Educ. 2020 Oct;46(5):455-464. doi: 10.1177/0145721720954070.

DOI:10.1177/0145721720954070

PMID:32998649

Abstract

PURPOSE

The purpose of the study was to evaluate the feasibility and effectiveness of a nurse-led mobile phone call intervention on glycemic management and adherence to self-management practices among patients with type 2 diabetes mellitus (T2DM) in Ghana.

METHODS

This was a pilot randomized controlled trial to compare diabetes care as usual to a mobile phone call intervention delivered by nurses in addition to care as usual over a 12-week period in a tertiary referral hospital in Ghana. Sixty patients with T2DM were randomized to either the intervention or the control arm. The intervention group received up to 16 mobile phone calls (mean duration = 12 minutes) from a diabetes specialist nurse in addition to their care as usual. The control group received only care as usual. The primary outcome was the change in A1C over the 12-week period. The secondary outcomes were changes in self-reported adherence to medication and diabetes self-management measures over the 12-week period.

RESULTS

Mean baseline A1C was comparable between the intervention and control groups (9.54%, SD = 2.00% vs 9.07%, SD = 1.72%, = .334). After 12 weeks, A1C was significantly lower in the intervention group compared to the control group. The difference in mean A1C in the control group rose by +0.26 ± 1.30% ( = .282; 95% CI, -0.23 to 0.75), whereas that of the intervention group reduced by -1.51 ± 2.67% ( = .004; 95% CI, -2.51 to -0.51). No improvements in self-management were recorded in the control group. In the intervention group, however, the only significant improvement was recorded in the area of foot care practices. Participant recruitment and retention were 100% without any attrition. About 87% (n = 26) of the intervention group completed at least 70% (≥11) of the calls. At the end of the trial, participants who received the intervention rated their satisfaction as 89.3% on average.

CONCLUSION

A mobile phone follow-up call by nurses emphasizing adherence to self-management practices is feasible and can improve short- to medium-term glycemic management among patients with T2DM.

摘要

目的

本研究旨在评估在加纳，护士主导的手机随访干预对 2 型糖尿病（T2DM）患者血糖管理和自我管理实践依从性的可行性和有效性。

方法

这是一项试点随机对照试验，比较了在加纳的一家三级转诊医院，12 周内除常规护理外，增加护士主导的手机随访（试验组）与仅常规护理（对照组）对 T2DM 患者的影响。将 60 例 T2DM 患者随机分为干预组或对照组。干预组最多接受 16 次（平均时长=12 分钟）由糖尿病专科护士拨打的电话，除此之外还接受常规护理。对照组仅接受常规护理。主要结局为 12 周内 A1C 的变化。次要结局为 12 周内自我报告的药物依从性和糖尿病自我管理措施的变化。

结果

干预组和对照组的基线 A1C 均值相近（9.54%，SD=2.00% vs 9.07%，SD=1.72%， =.334）。12 周后，干预组的 A1C 显著低于对照组。对照组的平均 A1C 差值增加了+0.26±1.30%（ =.282；95%CI，-0.23 至 0.75），而干预组的差值降低了-1.51±2.67%（ =.004；95%CI，-2.51 至 -0.51）。对照组的自我管理没有改善。然而，在干预组中，唯一显著改善的领域是足部护理实践。参与者招募和保留率为 100%，无任何流失。约 87%（n=26）的干预组完成了至少 70%（≥11 次）的电话随访。试验结束时，接受干预的参与者平均对其满意度评价为 89.3%。