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短信系统(SMS)和电话提醒干预将约 47%的 2 型糖尿病患者的 HbA1C 水平降低-一项试点研究的结果。

Intervention through Short Messaging System (SMS) and phone call alerts reduced HbA1C levels in ~47% type-2 diabetics-results of a pilot study.

机构信息

Department of Health System Management Studies, JSS Academy of Higher Education & Research (JSS AHER), Mysore, Karnataka, India.

Special Interest Group in Patient Care Management (SIG-PCM), Mysore, Karnataka, India.

出版信息

PLoS One. 2020 Nov 17;15(11):e0241830. doi: 10.1371/journal.pone.0241830. eCollection 2020.

Abstract

PURPOSE

Despite extensive research and newer methods of interventions, the incidence and prevalence of diabetes is increasing at an alarming rate. Currently, according to world health organization (WHO) statistics, 422 million individuals are suffering from diabetes worldwide. In India, recent estimates have reported a significant increase in the number of diabetics in the last decade. Poor dietary habits, minimal adherence to treatment regimens, lack of timely education are some of the contributing factors for increasing incidence and huge economic burden; which can be handled by life style behavior modifications backed up by hand holding through continuous education. Prior studies have demonstrated the efficacy of various self-management tools and educational programs in better disease management behaviors among individuals with diabetes. Among various self-management tools, educating the individuals and alerting them using mobile phone calls and short messaging system (SMS) are widely accepted due to (a) the increasing mobile phone users and (b) availability of short messaging systems in local languages in the recent years. Therefore, a pilot study was conducted to determine the benefit of educating patients through phone calls and SMS in the self-management of diabetes.

OBJECTIVES

The objective of the study is to determine the feasibility and utility of SMS and phone call-based interventions in the management of diabetes by comparing the HbA1c values.

METHODOLOGY

The study was conducted for a period of 14 months from December 2017 till Feb 2019. Out of 380 individuals initially enrolled into the study, 120 had completed the 14-months period. Diabetes education through SMS and phone calls was provided on regular basis, and HbA1C levels at baseline, 8-months and 14-months quantified. In addition, feedback on patients' satisfaction and utility of the SMS / Phone calls was collected using questionnaires.

RESULTS

Data from our study demonstrated that after 8-months of intervention through phone calls, a significant increase in the number of individuals with HbA1c in the range of 5.1 to 7.0 was observed (from 27 individuals at base line to 37 individuals after 8-months intervention). Much more significant improvement in the number of individuals with lower HbA1c was observed at 14-months of intervention, indicating the benefit of regular phone call-based system in managing diabetes. A Chi square (χ2) test was performed to examine if the frequencies in the cells varied at baseline and at 8 and 14 months.

CONCLUSION

Chronic diseases like diabetes needs awareness and education to patients in adopting disease self-management practices. As mobile phone users are increasing in number, providing diabetes management education through mobile phone intervention could be a viable strategy for controlling diabetes.

摘要

目的

尽管进行了广泛的研究和采用了新的干预措施,糖尿病的发病率和患病率仍在以惊人的速度上升。目前,根据世界卫生组织(WHO)的统计数据,全球有 4.22 亿人患有糖尿病。在印度,最近的估计报告显示,在过去十年中,糖尿病患者的数量显著增加。不良的饮食习惯、对治疗方案的坚持度低、缺乏及时的教育,这些都是发病率上升和巨大经济负担的部分原因;这些问题可以通过生活方式行为改变来解决,辅以持续的教育,对患者进行手把手地指导。先前的研究已经证明了各种自我管理工具和教育计划在改善糖尿病患者的疾病管理行为方面的有效性。在各种自我管理工具中,通过手机通话和短信服务(SMS)来教育个人并提醒他们,由于(a)使用手机的人数不断增加,以及(b)近年来当地语言的短信服务可用性,因此得到了广泛认可。因此,进行了一项试点研究,以确定通过电话和短信对患者进行教育在糖尿病自我管理中的益处。

目的

本研究的目的是通过比较糖化血红蛋白(HbA1c)值,确定基于短信和电话的干预措施在糖尿病管理中的可行性和实用性。

方法

该研究于 2017 年 12 月至 2019 年 2 月进行,为期 14 个月。最初有 380 名患者入组该研究,其中 120 名患者完成了 14 个月的研究。定期通过短信和电话进行糖尿病教育,并在基线、8 个月和 14 个月时量化 HbA1C 水平。此外,使用问卷调查收集了患者对短信/电话的满意度和实用性的反馈。

结果

我们的研究数据表明,经过 8 个月的电话干预,HbA1c 在 5.1 到 7.0 范围内的患者数量显著增加(从基线时的 27 例增加到干预 8 个月后的 37 例)。在 14 个月的干预后,HbA1c 水平较低的患者数量有了更显著的改善,这表明定期的电话系统在管理糖尿病方面是有益的。进行了卡方(χ2)检验,以检查细胞中的频率是否在基线时、8 个月和 14 个月时发生变化。

结论

像糖尿病这样的慢性病需要患者了解和接受教育,以使其采用疾病自我管理实践。随着手机用户数量的增加,通过手机干预提供糖尿病管理教育可能是控制糖尿病的一种可行策略。

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