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%, P = .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% (P = .282; 95% CI, −0.23 to 0.75), whereas that of the intervention group reduced by −1.51 ± 2.67% (P = .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.

中文翻译：

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在加纳市区促进2型糖尿病管理的试点手机干预：一项随机对照试验。

目的

这项研究的目的是评估加纳2型糖尿病（T2DM）患者中由护士主导的手机呼叫干预对血糖管理和坚持自我管理做法的可行性和有效性。

方法

这是一项试验性随机对照试验，用于比较加纳一家三级转诊医院在12周内照常照料与护士照常进行的手机呼叫干预之间的照护。60例T2DM患者被随机分配至干预组或对照组。除照常照料外，干预组还从糖尿病专科护士那里接到了多达16个手机电话（平均持续时间= 12分钟）。对照组仅照常接受护理。主要结果是12周内A1C的变化。次要结果是在12周内自我报告对药物的依从性和糖尿病自我管理措施的变化。

结果

干预组和对照组之间的平均基线A1C相当（9.54％，SD = 2.00％vs 9.07％，SD = 1.72％，P = .334）。12周后，干预组的A1C明显低于对照组。对照组的平均A1C差异增加+0.26±1.30％（P = .282; 95％CI，-0.23至0.75），而干预组的平均A1C差异则降低-1.51±2.67％（P= .004; 95％CI，-2.51至-0.51）。对照组的自我管理没有改善。但是，在干预组中，唯一的显着改善是在足部护理领域。参加者的招募和保留率均为100％，无任何损耗。干预组中约有87％（n = 26）完成了至少70％（≥11）的呼叫。在试验结束时，接受干预的参与者对他们的满意度平均为89.3％。

结论

护士通过手机随访电话强调坚持自我管理是可行的，并且可以改善T2DM患者的中短期血糖管理。