Authors (including presenting author) :
Wing Ka CHEUNG (1), King Yi LAI (1)
Affiliation :
(1) Paediatrics and Adolescent Medicine Department, United Christian Hospital
Introduction :
Diabetes mellitus is a common chronic disease in adolescents and diabetes self-management interventions are a fundamental part of diabetes care for them. In the United Christian hospital, around 50 adolescents are newly diagnosed with diabetes every year. Owing to adherence problems in the self-management, many of them usually present a high HbA1c level (>7.0 %). Multiple studies have highlighted the effectiveness of text message-based self-management interventions for improvement in glycemic control and self-efficacy including medication adherence, healthy eating and physical activity on adolescents with diabetes. However, the use of messaging app in patient care remains an innovative strategy and limited local services are provided in Hong Kong. Therefore, a systematic review and action plan are developed on the mentioned topic to support and motivate this local population by establishing text message-based self-management programme.
Objectives :
(1) To evaluate the effectiveness of text message-based self-management interventions on adolescents with diabetes; (2) To explore the service needs in pediatric department of a local hospital; (3) To develop a feasible action plan for the text message-based self-management programme.
Methodology :
A systematic search of Ovid MEDLINE, EMBASE, PubMed and CINAHLComplete was conducted. Experimental research studies published between 2010 and 2020 were included if they used text message-based self-management interventions. Data appraisal was performed using the Effective Public Health Practice Project Quality Assessment Tool. A randomised controlled pilot trial will be conducted in the United Christian Hospital over 9 months between January 2023 and September 2023. Patients (a) aged 13 to 18 years; (b) have confirmed diagnosis of type 1 or type 2 diabetes and (c) are able to operate WhatsApp will be recruited and randomly divided into an intervention group or a control group using a 1:1 ratio. The participants in the intervention group will participate in a 12-week text message-based diabetes self-management programme in addition to the usual care, while the participants in the control group will receive the routine telephone follow up in the paediatric inpatient wards. The outcome evaluation measures of this trial will be the changes in patients’ HbA1c level and their self-efficacy for diabetes management measured by the Summary of Diabetes Self-Care Activities scale. The outcome assessment will occur at baseline and 3 months after completion of the intervention.
Result & Outcome :
Five randomised controlled studies were included in the literature review. The findings in the review showed that text message-based self-management interventions are effective in reducing the HbAlc levels of adolescents with diabetes. Therefore, text message-based educational interventions can be used as an adjunct to traditional diabetes education. A text message-based diabetes self-management programme is needed to bridge the local service gap. The programme could potentially improve glycaemic control and self-efficacy among adolescents with diabetes. It is also costless, and convenient for patients to interact with healthcare professionals via text messaging. The potential barriers in implementation include unstable internet connection and the parents who may worry addiction problem to using mobile messaging app. The results of this trial can guide the design and implementation of larger-scale efficacy studies in the future.
