在COVID-19大流行期间,使用移动医疗技术为糖尿病患者提供患者教育是必要的。
这项开放标签的随机对照试验评估了通过社交媒体应用程序提供的糖尿病教育平台-台北医科大学-LINE定向视频教育的效果。
通过医生转诊从诊所招募2型糖尿病患者。基于社交媒体的节目包括51个视频:10个关于了解糖尿病,10关于日常护理,6关于营养护理,21关于糖尿病药物,和4个包含测验。干预组通过社交媒体平台每周收到两到三个视频,每两周收到一次护理信息,为期3个月,除了平时的护理。对照组仅接受常规护理。在基线和干预后3个月,通过自我报告的面对面问卷在临床就诊时测量结果。包括简化的糖尿病知识量表(真/假版本),糖尿病护理简介-对糖尿病量表的态度,糖尿病自我护理活动总结,糖化血红蛋白(HbA1c)水平。使用最新生命体征工具在基线测量健康素养。比较各组干预前后HbA1c水平和问卷评分的差异。知识的协会,态度,并评估了具有健康素养的自我保健活动。
2型糖尿病患者完成了为期3个月的研究,在181例患者中,91例(50.3%)在干预组中,90例(49.7%)在对照组中。两组之间的HbA1c变化没有显着差异(干预组:平均6.9%,SD0.8%至平均7.0%,SD0.9%,P=.34;对照组:平均6.7%,SD0.6%至平均值6.7%,SD0.7%,P=.91)。两组在12周时平均知识得分均增加,干预组从68.3%(SD16.4%)增加到76.7%(SD11.7%;P<.001),对照组从64.8%(SD18.2%)增加到73.2%(SD12.6%;P<.001)。仅在干预组中观察到态度和自我护理活动的积极改善(态度:平均差0.2,SD0.5,P=.001;自我护理活动:平均差0.3,SD1.2,P=.03)。21个药物相关视频中有8个(38%)实现了100%的实用率。低健康素养是干预组基线知识得分的显著危险因素,比值比为2.80(95%CI1.28-6.12;P=0.01);3个月后变得微不足道。
基于社交媒体的计划有效地增强了知识,态度,糖尿病患者的自我护理活动。这种干预也有助于健康素养较低的患者对糖尿病知识的了解。该计划代表了通过社交媒体向患者提供糖尿病教育的潜在有用工具,特别是在COVID-19大流行期间。
ClinicalTrials.govNCT04876274;https://clinicaltrials.gov/ct2/show/results/NCT04876274.
The use of mobile health technologies has been necessary to deliver patient education to patients with diabetes during the COVID-19 pandemic.
This open-label randomized controlled trial evaluated the effects of a diabetes educational platform-Taipei Medical University-LINE Oriented Video Education-delivered through a social media app.
Patients with type 2 diabetes were recruited from a clinic through physician referral. The social media-based program included 51 videos: 10 about understanding diabetes, 10 about daily care, 6 about nutrition care, 21 about diabetes drugs, and 4 containing quizzes. The intervention group received two or three videos every week and care messages every 2 weeks through the social media platform for 3 months, in addition to usual care. The control group only received usual care. Outcomes were measured at clinical visits through self-reported face-to-face questionnaires at baseline and at 3 months after the intervention, including the Simplified Diabetes Knowledge Scale (true/false version), the Diabetes Care Profile-Attitudes Toward Diabetes Scales, the Summary of Diabetes Self-Care Activities, and glycated hemoglobin (HbA1c) levels. Health literacy was measured at baseline using the Newest Vital Sign tool. Differences in HbA1c levels and questionnaire scores before and after the intervention were compared between groups. The associations of knowledge, attitudes, and self-care activities with health literacy were assessed.
Patients with type 2 diabetes completed the 3-month study, with 91 out of 181 (50.3%) patients in the intervention group and 90 (49.7%) in the control group. The change in HbA1c did not significantly differ between groups (intervention group: mean 6.9%, SD 0.8% to mean 7.0%, SD 0.9%, P=.34; control group: mean 6.7%, SD 0.6% to mean 6.7%, SD 0.7%, P=.91). Both groups showed increased mean knowledge scores at 12 weeks, increasing from 68.3% (SD 16.4%) to 76.7% (SD 11.7%; P<.001) in the intervention group and from 64.8% (SD 18.2%) to 73.2% (SD 12.6%; P<.001) in the control group. Positive improvements in attitudes and self-care activities were only observed in the intervention group (attitudes: mean difference 0.2, SD 0.5, P=.001; self-care activities: mean difference 0.3, SD 1.2, P=.03). A 100% utility rate was achieved for 8 out of 21 (38%) medication-related videos. Low health literacy was a significant risk factor for baseline knowledge scores in the intervention group, with an odds ratio of 2.80 (95% CI 1.28-6.12; P=.01); this became insignificant after 3 months.
The social media-based program was effective at enhancing the knowledge, attitudes, and self-care activities of patients with diabetes. This intervention was also helpful for patients with low health literacy in diabetes knowledge. The program represents a potentially useful tool for delivering diabetes education to patients through social media, especially during the COVID-19 pandemic.
ClinicalTrials.gov NCT04876274; https://clinicaltrials.gov/ct2/show/results/NCT04876274.