Abstract
Purpose :
To examine the effectiveness of a culturally appropriate patient-centred educational and intervention program, developed using videos and one-to-one interaction by a multidisciplinary team of experts, in newly diagnosed diabetic patients in Nepal.
Methods :
110 patients [Fasting blood sugar (FBS) >126 or random >200 mg/dL] were recruited and randomly allocated to either an intervention or non-intervention group. Both groups received the recommended treatment for their diabetes and were followed up after three months. The intervention group were invited to an educational workshop and were provided with custom-designed physical activity and diet improvement plans. A dedicated helpline telephone number was available everyday for the patients, and each patient on the intervention group was contacted every week to ask about their progress and deal with any issues. The non-intervention group received the normal care of three months follow-up without the educational program or additional support. We report preliminary data from 45 patients in the intervention and 34 patients in the non-intervention group who attended both visits. Primary outcome measures were changes in HbA1c, FBS, awareness about diabetes and uptake of retinal screening.
Results :
Age, baseline HbA1c and FBS did not differ significantly between groups (p>0.05). After three months, the intervention group showed significant improvements in HbA1c and FBS compared to the non-intervention group. A two (patient groups)×two (visits) ANOVA showed a significant main effect of visits on HbA1c (p<0.01) and FBS (p<0.01). Post-hoc comparisons showed significantly lowered HbA1c (p<0.01) and FBS (p<0.01) for the intervention group at the follow-up visit. Significantly higher number of patients reported attending retinal screening and eating less white rice in the intervention group (p<0.01). Improved knowledge in the intervention group was also evidenced by more patients being aware of normal blood sugar levels and lifestyle influences such as stress.
Conclusions :
The intervention group showed better control of their diabetes and improved knowledge/awareness after three months. The uptake of retinal screening was also significantly greater. Culturally and linguistically appropriate programs can lead to improved diabetes control and consequently reduced risk of diabetic eye complications.
This is a 2020 ARVO Annual Meeting abstract.