Abstract
Background Family support is crucial in the care of older patients with diabetes. However, more information is needed to evaluate the potential benefits of family-based intervention through a mobile application by pharmacists in the older diabetes patients. Aim To evaluate the effectiveness of family support-based intervention via a mobile application by pharmacists on clinical outcomes, family behaviour, diabetes knowledge, self-management practices and medication adherence in older adults with type 2 diabetes. Method A randomised controlled trial was conducted in a hospital in the south of Thailand with 9 months of follow-up. Family members in the intervention group (n = 78) received diabetes educational courses and encouragement via a mobile application from pharmacists to help their older relatives with diabetes in self-management tasks. The control group received usual care (n = 79). Results As compared to baseline, significant improvements were observed in the intervention patients for glycosylated haemoglobin (HbA1c), blood pressure, family behaviour in diabetes care, diabetes knowledge, self-management practices and medication adherence (P < 0.001). The intervention group showed greater decline in HbA1c levels relative to the control group (− 0.97% vs. − 0.12%; P = 0.001). Significant differences between groups for changes in blood pressure levels including scores of family behaviour, diabetes knowledge, self-management and medication adherence were found (P ≤ 0.001), with the intervention group showing greater improvement. Conclusion Family support intervention via a mobile application by pharmacists is beneficial to diabetes care for older adults.
Trial registration number: TCTR20200615001 (date 13 June 2020, retrospectively registered).
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References
International Diabetes Federation (IDF). IDF diabetes atlas. 2019. http://www.diabetesatlas.org. Accessed 01 Jul 2021
American Diabetes Association. Standards of medical care in diabetes-2021. Diabetes Care. 2021;44(suppl 1):S1-179.
Atif M, Saleem Q, Babar ZU, et al. Association between the vicious cycle of diabetes-associated complications and glycemic control among the elderly: a systematic review. Medicina. 2018;54:73.
Sesti G, Antonelli Incalzi R, Bonora E, et al. Management of diabetes in older adults. Nutr Metab Cardiovasc Dis. 2018;28:206–18.
Lee AA, Piette JD, Heisler M, et al. Diabetes distress and glycemic control: the buffering effect of autonomy support from important family members and friends. Diabetes Care. 2018;41:1157–63.
Shao Y, Liang L, Shi L, et al. The effect of social support on glycemic control in patients with type 2 diabetes mellitus: the mediating roles of self-efficacy and adherence. J Diabetes Res. 2017;2017:2804178.
Lambert SD, Bowe SJ, Livingston PM, et al. Impact of informal caregiving on older adults’ physical and mental health in low-income and middle-income countries: a cross-sectional, secondary analysis based on the WHO’s study on global ageing and adult health (SAGE). BMJ Open. 2017;7:e017236.
Shi M, Xu MY, Liu ZL, et al. Effectiveness of family involvement in newly diagnosed type 2 diabetes patients: a follow-up study. Patient Educ Couns. 2016;99:776–82.
Wichit N, Mnatzaganian G, Courtney M, et al. Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with type 2 diabetes. Diabetes Res Clin Pract. 2017;123:37–48.
Withidpanyawong U, Lerkiatbundit S, Saengcharoen W. Family-based intervention by pharmacists for type 2 diabetes: a randomised controlled trial. Patient Educ Couns. 2019;102:85–92.
Kristianingrum ND, Wiarsih W, Nursasi AY. Perceived family support among older persons in diabetes mellitus self-management. BMC Geriatr. 2018;18(suppl 1):304.
Yu Y, Yan Q, Li H, et al. Effects of mobile phone application combined with or without self-monitoring of blood glucose on glycemic control in patients with diabetes: a randomized controlled trial. J Diabetes Investig. 2019;10:1365–71.
Agarwal P, Mukerji G, Desveaux L, et al. Mobile app for improved self-management of type 2 diabetes: multicenter pragmatic randomized controlled trial. JMIR Mhealth Uhealth. 2019;7:e10321.
Jeffrey B, Bagala M, Creighton A, et al. Mobile phone applications and their use in the self-management of type 2 diabetes mellitus: a qualitative study among app users and non-app users. Diabetol Metab Syndr. 2019;11:84.
Bukhsh A, Nawaz MS, Ahmed HS, et al. A randomized controlled study to evaluate the effect of pharmacist-led educational intervention on glycemic control, self-care activities and disease knowledge among type 2 diabetes patients: a consort compliant study protocol. Medicine. 2018;97:e9847.
Korcegez EI, Sancar M, Demirkan K. Effect of a pharmacist-led program on improving outcomes in patients with type 2 diabetes mellitus from Northern Cyprus: a randomized controlled trial. J Manag Care Spec Pharm. 2017;23:573–82.
Tchero H, Kangambega P, Briatte C, et al. Clinical effectiveness of telemedicine in diabetes mellitus: a meta analysis of 42 randomized controlled trials. Telemed J E Health. 2019;25:569–83.
American Diabetes Association. Standards of medical care in diabetes-2018. Diabetes Care. 2018;41(suppl 1):S1-159.
Glasgow RE, Toobert DJ. Social environment and regimen adherence among type II diabetic patients. Diabetes Care. 1988;11:377–86.
Wongwiwatthananukit S, Krittiyanunt S, Wannapinyo A. Development and validation of an instrument to assess the general knowledge of patients with diabetes. Thai J Pharm Sci. 2004;28:17–29.
Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000;23:943–50.
Dal Canto E, Ceriello A, Ryden L, et al. Diabetes as a cardiovascular risk factor: an overview of global trends of macro and microvascular complications. Eur J Prev Cardiol. 2019;26(2 suppl):25–32.
Kodama S, Morikawa S, Horikawa C, et al. Effect of family-oriented diabetes programs on glycemic control: a meta-analysis. Fam Pract. 2019;36:387–94.
McGurnaghan S, Blackbourn LAK, Mocevic E, et al. Cardiovascular disease prevalence and risk factor prevalence in type 2 diabetes: a contemporary analysis. Diabet Med. 2019;36:718–25.
Lee E, Park E. Self-care behavior and related factors in older patients with uncontrolled hypertension. Contemp Nurse. 2017;53:607–21.
Bukhsh A, Khan TM, Sarfraz Nawaz M, et al. Association of diabetes knowledge with glycemic control and self-care practices among Pakistani people with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2019;12:1409–17.
Getie A, Geda B, Alemayhu T, et al. Self- care practices and associated factors among adult diabetic patients in public hospitals of Dire Dawa administration, Eastern Ethiopia. BMC Public Health. 2020;20:1232.
Pesantes MA, Del Valle A, Diez-Canseco F, et al. Family support and diabetes: patient’s experiences from a public hospital in Peru. Qual Health Res. 2018;28:1871–82.
Mayberry LS, Piette JD, Lee AA, et al. Out-of-home informal support important for medication adherence, diabetes distress, hemoglobin A1c among adults with type 2 diabetes. J Behav Med. 2019;42:493–501.
Horii T, Momo K, Yasu T, et al. Determination of factors affecting medication adherence in type 2 diabetes mellitus patients using a nationwide claim-based database in Japan. PLoS One. 2019;14:e0223431.
Acknowledgements
The authors are grateful to all participants and their family members for contribution in this study. We would like to acknowledge Prof. Dr. Deborah J. Toobert, Prof. Dr. Russell E. Glasgow and Prof. Dr. Supakit Wongwiwatthananukit for granting the permission to use their instruments. We also acknowledge Dr. Alan Geater for editorial assistance with the manuscript.
Funding
This study was supported by Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand (Grant Number PHA6104057S).
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Poonprapai, P., Lerkiatbundit, S. & Saengcharoen, W. Family support-based intervention using a mobile application provided by pharmacists for older adults with diabetes to improve glycaemic control: a randomised controlled trial. Int J Clin Pharm 44, 680–688 (2022). https://doi.org/10.1007/s11096-022-01389-5
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DOI: https://doi.org/10.1007/s11096-022-01389-5