Effectiveness of diabetes self-care education at primary health care centres in Saudi Arabia: A pragmatic randomized trial in Tabuk

Fakhralddin Abbas Mohammed Elfakki, Mustafa Khidir Elnimeiri, Sami Mahmoud Assil, Ehab Ahmed Frah, Nada Hassan Ibrahim Abdalla, Fakhralddin Abbas Mohammed Elfakki, Mustafa Khidir Elnimeiri, Sami Mahmoud Assil, Ehab Ahmed Frah, Nada Hassan Ibrahim Abdalla

Abstract

Objective: The present trial aimed to assess the effectiveness of the structured Information, Education, and Communication provided by trained health educators at primary care on the mean body mass index, waist circumference, fasting blood glucose, and the level of blood pressure, among patients with type 2 diabetes mellitus.

Research methods: This was a 12-month pragmatic clustered randomized trial where 180 patients with type 2 diabetes mellitus were enrolled in 2020. Five primary health care centres were randomly allocated to either the intervention or control arm.

Results: There was a comparable significant reduction in the mean scores of waist circumference among participants in the intervention versus control arm over 12 months: I =108.7:C = 85.8 cm (P value = 0.001), I = 109.2:C = 86.02 cm (P value = 0.001), and I = 105.6:C = 87.2 cm (P value = 0.001) in the first, sixth, and twelfth months, respectively. A significant reduction in the mean scores of body mass index in the intervention versus control arm only in the first month: I =31.7:C = 26.5 cm (P value = 0.001). However, there was a comparable significant reduction in the mean scores of fasting blood glucose in the intervention versus control arm over 12 months: I =2016.5:C = 185.3 mmol/l (P value = 0.011), I = 207.4:C = 168.04 mmol/l (P value = 0.002), and I = 2012.7:C = 158.6 mmol/l (P value = 0.001) in the first, sixth, and twelfth months, respectively.

Conclusions: The delivery of structured diabetes self-care education for diabetics by trained health educators at primary health care has a beneficiary effect on reducing the mean body mass index, waist circumference, and blood glucose. Similarly, it decreases high blood pressure.

Keywords: Diabetes; health educator; pragmatic trial; primary health care; self-education.

Conflict of interest statement

There are no conflicts of interest.

Copyright: © 2022 Journal of Family Medicine and Primary Care.

Figures

Figure 1
Figure 1
Patient flow chart
Figure 2
Figure 2
Mean scores of body mass index over 12th months
Figure 3
Figure 3
Mean scores of waist circumference
Figure 4
Figure 4
Mean scores of fasting blood glucose over 12 months
Figure 5
Figure 5
Proportion of high blood pressure over 12 months
Figure 6
Figure 6
Reflects improvment in the level of normal blood pressure in the intervention arm throughout the trial

References

    1. Arokiasamy P, Salvi S, Selvamani Y. Global Burden of Diabetes Mellitus. Handbook of Global Health. 2020:1–44.
    1. Ryan D, Burke SD, Litchman ML, Bronich-Hall L, Kolb L, Rinker J, Yehl K. Competencies for diabetes care and education specialists. The Diabetes Educator. 2020;46:384–97.
    1. Chai S, Yao B, Xu L, Wang D, Sun J, Yuan N. The effect of diabetes self-management education on psychological status and blood glucose in newly diagnosed patients with diabetes type 2. Patient Educ Couns. 2018;101:1427–32.
    1. Al Slamah T, Nicholl BI, Alslail FY, Melville CA. Self-management of type 2 diabetes in gulf cooperation council countries:A systematic review. PloS One. 2017;12:1–11.
    1. American Diabetes Association. Facilitating behavior change and well-being to improve health outcomes:Standards of Medical Care in Diabetes—2020. Diabetes Care. 2020;43(Suppl 1):S48–65.
    1. Begum S. The impact of the NSF for Diabetes on patient empowerment. Br J Nurs. 2010;19:887–90.
    1. Ye W, Kuo S, Kieffer EC, Piatt G, Sinco B, Palmisano G, et al. Cost-effectiveness of a diabetes self-management education and support intervention led by community health workers and peer leaders:Projections from the racial and ethnic approaches to community health detroit trial. Diabetes Care. 2021;44:1108–15.
    1. Baviskar MP, Rangari S, Mishra S, Mohanta BS. Assessment of a group-based comprehensive diabetes management program to improve glycemic control, quality of life and self-care behavior in patients with type 2 diabetes mellitus in a primary healthcare setting of a metropolitan city in India:CDMP MUM Trial. Int J Diabetes Dev Ctries. 2021;41:156–63.
    1. Al Saffer Q, Al-Ghaith T, Alshehri A, Al-Mohammed R, Al Homidi S, Hamza MM, et al. The capacity of primary health care facilities in Saudi Arabia:Infrastructure, services, drug availability, and human resources. BMC Health Serv Res. 2021;21:1–15.
    1. Al Busaidi N, Shanmugam P, Manoharan D. Diabetes in the Middle East:Government health care policies and strategies that address the growing diabetes prevalence in the Middle East. Curr Diab Rep. 2019;19:8.
    1. Zwarenstein M, Treweek S, Gagnier JJ, Altman DG, Tunis S, Haynes B, et al. Improving the reporting of pragmatic trials:An extension of the CONSORT statement. BMJ. 2008;337:a2390.
    1. Alluhaymid YM, Alessa YA, Alhikan AA, Albalawi GA, Alrasheed WA, Aldawasari HK, et al. Educational interventions in type 2 diabetes mellitus patients in primary health care:Systematic review and meta-analysis. Ann Med Health Sci Res. 2021;11:1217–21.
    1. Wang Y, Min J, Khuri J, Xue H, Xie B, A Kaminsky L, et al. Effectiveness of mobile health interventions on diabetes and obesity treatment and management:Systematic review of systematic reviews. JMIR MHealth UHealth. 2020;8:e15400.
    1. Jiang XJ, Jiang H, Chen Y, Wu XA, Yu XL, Liu L, et al. The effectiveness of a self-efficacy-focused structured education program (SSEP) in improving metabolic control and psychological outcomes of type 2 diabetes patients:A 12-month follow-up of a multicenter randomized controlled trial. Diabetes Metab Syndr Obes Targets Ther. 2021;14:305–13.
    1. Teston EF, Spigolon DN, Maran E, de L Santos A, Matsuda LM, Marcon SS. Nurses'perspective on health education in Diabetes Mellitus Care. Rev Bras Enferm. 2018;71:2735–42.
    1. Samudera WS, Efendi F, Indarwati R. Effect of community and peer support based healthy lifestyle program (CP-HELP) on self care behavior and fasting blood glucose in patient with type 2 Diabetes Mellitus. J Diabetes Metab Disord. 2021;20:193–9.
    1. Park S, Kim J, Lee J. Effects of exercise intervention on adults with both hypertension and type 2 diabetes mellitus:A systematic review and meta-analysis. J Cardiovasc Nurs. 2021;36:1–7.
    1. Momin M, Fan F, Li J, Jia J, Zhang L, Zhang Y, et al. Joint effects of body mass index and waist circumference on the incidence of hypertension in a community-based Chinese population. Obes Facts. 2020;13:245–55.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit