The Effect of a Patient Activation Tailored Intervention on Type 2 Diabetes Self-Management and Clinical Outcomes: A Study from Saudi Arabian Primary Care Settings.

Publisher: Hindawi Limited Country of Publication: England NLM ID: 101605237 Publication Model: eCollection Cited Medium: Internet ISSN: 2314-6753 (Electronic) NLM ISO Abbreviation: J Diabetes Res Subsets: MEDLINE

Publication: <2019>-: London, United Kingdom : Hindawi Limited
Original Publication: Nasr City, Cairo : Hindawi Publishing Corporation, [2013]-

Diabetes Mellitus, Type 2* ; Self-Management*; Humans ; Female ; Adult ; Middle Aged ; Adolescent ; Male ; Saudi Arabia ; Patient Participation ; Quality of Life ; Primary Health Care

Background: Type 2 diabetes mellitus (T2DM) is a global public health challenge. T2DM self-management, including diet, physical activity, blood glucose self-monitoring, foot care, and adherence to medication, is considered a primary tool for managing diabetes. Patient activation, an individual's knowledge, skill, and confidence in managing their health and healthcare, was recognized to be associated with better T2DM self-management and clinical outcomes. Patient activation intervention has been described as a potential approach for enhancing chronic disease self-management. This study is aimed at examining the effect of a patient activation-tailored intervention on T2DM self-management and clinical outcomes in primary care settings in Saudi Arabia.
Method: A pre- and postintervention study was conducted among ≥18 years old T2DM patients attending primary healthcare centers in Saudi Arabia. Collected data included demographics, clinical data, the Patient Activation Measure (PAM), the Summary of Diabetes Self-Care Activities (SDSCA), the diabetes knowledge test (DKT2), the problem area in diabetes test (PAID-5), and the diabetes quality of life test (DQOL). The intervention was tailored based on the participants' patient activation level. The intervention consisted of monthly face-to-face sessions for three months and a telephone follow-up per month for three months postintervention. Descriptive statistics, a paired sample t -test for scale variables, and Wilcoxon's signed-rank test for categorical variables were used for data analysis.
Results: A total of 82 patients, mostly female (61%) with a mean age of 51.3 ± 9.9 years old, completed baseline and postintervention surveys. After six months of intervention, there was a significant change in patient activation score from 54.74 to 61.58 ( p < 0.001), hemoglobin A1c (HbA1c) from 8.38 to 7.55 ( p < 0.001), and body mass index (BMI) from 30.90 to 29.16 ( p < 0.001). Also, there was a significant change in SDSCA scores (diet from 3.12 to 3.67, exercise from 2.54 to 3.49, and blood glucose self-testing from 2.37 to 3.24) ( p < 0.001) and DKT from 6.29 to 7.22 ( p = 0.01).
Conclusion: Our findings suggested that tailoring interventions based on patients' activation levels is more likely to yield promising T2DM self-management and clinical outcomes.
Competing Interests: The authors have no conflict of interest to declare.
(Copyright © 2023 Nasser Almutairi et al.)

J Pers Med. 2022 Aug 30;12(9):. (PMID: 36143195)
Patient Educ Couns. 2012 Aug;88(2):338-43. (PMID: 22459636)
Diabetes Care. 2000 Jul;23(7):943-50. (PMID: 10895844)
Res Nurs Health. 2008 Apr;31(2):180-91. (PMID: 18183564)
Ann Fam Med. 2010 Sep-Oct;8(5):410-7. (PMID: 20843882)
Diabet Med. 2020 Jul;37(7):1146-1154. (PMID: 32392380)
Diabetologia. 2010 Jan;53(1):66-9. (PMID: 19841892)
J Transcult Nurs. 2016 Jan;27(1):65-72. (PMID: 24841470)
Health Aff (Millwood). 2013 Feb;32(2):207-14. (PMID: 23381511)
J Endocrinol Invest. 2022 Apr;45(4):763-772. (PMID: 34780052)
Nat Rev Endocrinol. 2018 Feb;14(2):88-98. (PMID: 29219149)
Prim Care Diabetes. 2020 Feb;14(1):12-20. (PMID: 31543458)
Health Serv Res. 2004 Aug;39(4 Pt 1):1005-26. (PMID: 15230939)
Spine (Phila Pa 1976). 2008 Oct 1;33(21):E784-91. (PMID: 18827683)
J Nurs Res. 2020 Oct;28(5):e116. (PMID: 32649394)
Aust J Prim Health. 2020 Dec;26(6):431-442. (PMID: 33222755)
J Am Geriatr Soc. 2010 Aug;58(8):1496-503. (PMID: 20662953)
Patient Educ Couns. 2002 Oct -Nov;48(2):177-87. (PMID: 12401421)
J Cardiovasc Nurs. 2013 Jan-Feb;28(1):20-34. (PMID: 22343209)
J Gen Intern Med. 2014 Aug;29(8):1166-76. (PMID: 24733301)
Diabetes Educ. 2012 Sep-Oct;38(5):619-29. (PMID: 22996411)
Diabetes Metab Syndr. 2020 Nov-Dec;14(6):1603-1605. (PMID: 32862099)
J Family Community Med. 2017 Sep-Dec;24(3):164-172. (PMID: 28932161)
J Gen Intern Med. 2012 May;27(5):520-6. (PMID: 22127797)
Health Serv Res. 2007 Aug;42(4):1443-63. (PMID: 17610432)
Diabetol Int. 2021 May 12;13(1):108-116. (PMID: 33996370)
Patient Educ Couns. 2017 Jul;100(7):1268-1275. (PMID: 28159442)
Diabetes Care. 1997 May;20(5):760-6. (PMID: 9135939)
Patient Educ Couns. 2020 Apr;103(4):848-853. (PMID: 31676100)
Diabetes Educ. 2016 Apr;42(2):178-87. (PMID: 26769757)
Br J Health Psychol. 2004 Sep;9(Pt 3):365-79. (PMID: 15296683)
Health Serv Res. 2005 Dec;40(6 Pt 1):1918-30. (PMID: 16336556)
Diabetes Care. 2010 Jan;33 Suppl 1:S62-9. (PMID: 20042775)
J Diabetes Res. 2016;2016:9643714. (PMID: 27995149)
Patient Educ Couns. 2009 Jun;75(3):328-33. (PMID: 19167857)
PLoS One. 2015 May 08;10(5):e0125820. (PMID: 25954817)
J Ambul Care Manage. 2009 Oct-Dec;32(4):320-7. (PMID: 19888008)
BMJ. 2000 Aug 12;321(7258):405-12. (PMID: 10938048)
J Family Community Med. 2013 May;20(2):77-82. (PMID: 23983558)
Diabetes Care. 2011 Jan;34 Suppl 1:S89-96. (PMID: 21193633)
Diabetes Metab Syndr. 2020 Jul - Aug;14(4):303-310. (PMID: 32298981)
J Ambul Care Manage. 2007 Jan-Mar;30(1):21-9. (PMID: 17170635)
BMJ Open Diabetes Res Care. 2020 Dec;8(2):. (PMID: 33323460)

Date Created: 20231207 Date Completed: 20231211 Latest Revision: 20231211

20231215

PMC10696472

10.1155/2023/2074560

38059208