Mobile Health Intervention for Improved Adherence in Type 2 Diabetes
Study Details
Study Description
Brief Summary
The study assessed patients' glycemic control, knowledge of type 2 diabetes (T2D) and adherence to medications, and evaluated the impact of a mobile telephone-based intervention on these indices. Patients' clinic attendance and pharmacy refill records were reviewed for the period of 1 year. Then over a period of 1 month, newly diagnosed T2D patients were enrolled in the prospective phase of the study and randomized into control and intervention groups. A mobile phone-based health education and follow-up package was applied to the intervention group alone for a period of 6 months. Afterwards, both groups were assessed and compared on the study outcome parameters. Same questionnaires were used pre- and post-intervention for primary data collection. Descriptive and inferential statistics were used for data analysis.
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Detailed Description
Objectives of the Study: The study assessed patients' glycemic control, knowledge of type 2 diabetes (T2D) and adherence to medications, and evaluated the impact of a mobile telephone-based intervention on these indices.
Study design: Randomized controlled trial Study Setting: Diabetes Clinic, Endocrinology Unit, Department of Internal Medicine, Obafemi Awolowo University Teaching Hospital Ile Ife, Osun
State Nigeria The study was structured in five stages. Study Duration: Seven months Stage 1:
Baseline data Task 1: Baseline data for patients' glycemic control were obtained from one-year retrospective review of 1392 patients' files for glycated haemoglobin (HbA1c) measurements.
Task 2: Patients' baseline adherence data were obtained from one-year retrospective review of pharmacy refill records (clinic attendance) Task 3: Development and validation of research instruments (Questionnaires, Short Message Services (SMS).
Task 4: Recruitment and training of research assistants (2 hours daily for 3 days) Stage 2:
Recruitment and randomization of participants Task 1: Enrolment of all newly-diagnosed patients (n = 120), enrolled in the Diabetes Clinic in the period of one month following Stage 1 Task 2: Obtaining of informed consent from all newly-diagnosed patients enrolled in the Diabetes Clinic in the one month following Stage 1 Task 3: Collection of participants' baseline knowledge data using structured questionnaire Task 4: Collection of baseline self-reported adherence data using the adapted 8-point Morisky Medication Adherence Scale (MMAS-8) instrument Task 5: Randomization of consenting participants into two equal (n = 60) control and intervention groups using a randomization software Stage 3: Intervention Task 1: Activation of short message services to participants in the intervention cohort at a frequency of one message per day for the period of 6 months.
Task 2: Follow up on clinic attendances of all participants for the period of 6 months Stage 4: Post-Intervention Review Task 1: Repeat administration of same questionnaires originally administered at Stage 2 to all participants Task 1: Review of participants' clinic attendance and pharmacy refill records Task 2: Review of participants HbA1c measurements from their records Stage 5: Data analysis Task 1: Demographic variables of participants were analyzed using descriptive statistics including frequency and percentages Task 2: Weighted mean scores were used to analyze knowledge and adherence scores Task 3: Two-sample t-test was used to compare pre- and post-intervention scores of knowledge and adherence Task 4: Chi square test was conducted to analyze associations between demographic variables and self-reported adherence data Task 5: Statistical package for the social sciences (SPSS) version 21 for windows software was used for data analysis at the p < 0.05 level of significance
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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No Intervention: control group Type 2 diabetes patients, 18 years old and above, enrolled in the out-patient, diabetes clinic of the tertiary health facility, receiving only standard of care, and who gave their informed consent |
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Experimental: intervention group type 2 diabetes patients, 18 years old and above, enrolled in the out-patient diabetes clinic of the tertiary health facility, receiving standard of care in addition to a mobile phone - based health education and follow-up messaging on a frequency of once a day corresponding to how often they are expected to take their medications (that is every day), and who gave their informed consent. |
Other: mobile phone-based health information
health education and follow-up messaging, randomly assigned to each participant in the intervention arm using a randomization software, delivered once daily, as short message service (sms)
Other Names:
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Outcome Measures
Primary Outcome Measures
- Primary outcome measure [6 Months]
Reduction in glycated hemoglobin (HbA1c), measured using blood tests, expressed in mmol/mol (%)
Secondary Outcome Measures
- Secondary outcome measure I [6 months]
Knowledge of diabetes, measured as by the mean score of participants in a questionnaire-based survey
- Secondary outcome measure II [6 months]
Adherence to medication, measured by the mean score of participants in a questionnaire-based survey
Eligibility Criteria
Criteria
Inclusion Criteria:
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Diagnosed of type 2 diabetes for the first time in the month following baseline study
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Male or female, 18 yeas of age and above
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Enrolled in the Out-patient Diabetes Clinic of the Teaching Hospital
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Gave informed consent to participate.
Exclusion Criteria:
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Diagnosed of other disease conditions outside type 2 diabetes
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Below 18 years of age
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Not enrolled in the Out-patient Diabetes Clinic of the Teaching Hospital
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Did not give informed consent
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Obafemi Awolowo University Teaching Hospital Complex | Ile Ife | Osun | Nigeria | 234 |
Sponsors and Collaborators
- Obafemi Awolowo University
Investigators
- Study Director: Kanayo Osemene, Ph.D., Department of Clinical Pharmacy and Pharmacy Administration, Obafemi Awolowo University, Ile Ife Nigeria
Study Documents (Full-Text)
None provided.More Information
Publications
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