A Pilot Test for Implementing Precision Healthcare Programme in Patients with Diabetes in Indonesia

Background/Aim: An evaluation of precision healthcare interventions among patients with diabetes in a small sample through a pilot test before being tested in a larger sample is needed. Thus, the purpose of this study was to evaluate the feasibility of a precision healthcare program. It also assesses the program's outcome among patients with diabetes in Indonesia. Methods: Data were collected during December 2020. The researchers first gathered data about participant characteristics. Furthermore, the strategies of precision healthcare were implemented in sixty respondents to evaluate the feasibility and outcome of the program in a month. Results: The participants mention that they can follow all procedures of precision healthcare. However, they asked the researcher to provide a guide and monitoring book which provides safe choices information on diet, exercise, glucose monitoring and drug medication. Moreover, participants mentioned that they could complete all questionnaires but needed a company of a research assistant. The benefits of a month of precision healthcare were improved diabetes self-care activity, blood pressure and blood glucose level. However, the body weight, body mass index (BMI), triglyceride, cholesterol and triglyceride glucose index were not significantly improved. Conclusion: A pilot test is needed to ensure the feasibility of the implementation strategy with the culture and background of diabetic patients in Indonesia. Improving diabetes self-care activity stabilised blood pressure and blood glucose during a month, so it can be assumed that precision healthcare approaches were potentially being applied in Indonesia. On the other hand, it is needed more than a month to improve body weight, body mass index (BMI), triglyceride, cholesterol and triglyceride glucose index. Thus, testing the precision healthcare approach in a larger sample with long time series for patients with diabetes in Indonesia through a randomised controlled trial (RCT) is needed

Effectiveness of Tailored Care Intervention Program on Biochemical Outcomes of Patients With Diabetes in Indonesia: A Randomized Controlled Trial

Background: Although patients with diabetes have common problems, their educational needs may differ, and they have the right to participate in planning and implementing individual or group healthcare programs. Because there are no proper care interventions for diabetic patients in Indonesia, this study evaluated the efficacy of a tailored care intervention program on some blood biochemical outcomes among Indonesian patients with diabetes.  Methods: We conducted a randomized controlled trial (RCT) with a pre-test-post-test design. We recruited 163 diabetic patients referred to Moyo Hilir and Moyo Hulu primary healthcare facilities in Sumbawa City, Indonesia, from January to April 2021. The subjects were randomly assigned to either intervention (n=80) or control (n=83) groups. The intervention group received a tailored care intervention program with 7 elements implemented through four stages: 1) brief deductive teaching, 2) self-management assessment, 3) brainstorming and support group, and 4) Follow-up. The control group received routine education. The study data were collected at baseline and three months after the intervention. The outcome measures were blood glucose levels, cholesterol, triglyceride, and triglyceride glucose index. IBM SPSS software, version 20 was used for statistical analysis. The obtained data were analyzed by descriptive (frequency distributions, percentages, Mean±SD) and inferential statistics (Chi-square, independent t-test, and paired t-test). The significance level was set at P<0.05.  Results: According to the independent t-test, there were no significant differences in blood glucose levels of the groups before and after the intervention. There were also no significant differences in the groups’ cholesterol, triglyceride, and triglyceride glucose index before the intervention, but significant differences were seen after the intervention (P=0.000). However, the significance moved in a negative direction. According to paired t-test, blood glucose level, triglyceride, and triglyceride glucose index increased in the control group but decreased in the intervention group, although it was not significant. On the other hand, cholesterol levels increased in both intervention and control groups, which was not significant. Conclusion: Although no significant findings were obtained, the glucose level, triglyceride, and glucose triglyceride index values of the intervention group were better than the control group, but not in terms of cholesterol level. Tailored care intervention programs can improve biochemical indicators, especially for blood glucose levels, triglycerides, and triglyceride glucose index; however, it seems that a follow-up study beyond three months is needed to be performed in the future

Effects of The Tailored Intervention Program in Lowering Blood Glucose Levels and Diabetes Distress Among Patients with Diabetes in Indonesia: A Randomized Controlled Trial

Introduction: Blood glucose levels and diabetes distress are the foremost factors contributing to diabetes treatment outcomes and managements. No tailored intervention program was implemented for patients with diabetes in Indonesia. This study aimed to investigate the effectiveness of a tailored intervention program in lowering blood glucose levels and diabetes distress among patients with diabetes patients in Indonesia. Methods: A randomized controlled trial (RCT) with pre-test and post-tests was applied. A total of 163 people with diabetes were collected for both intervention (n=80) and control (n=83) groups: A diabetes-tailored intervention program was attempted in the intervention group. Descriptive statistics, Analysis of Variant (ANOVA) and inferential statistics were used to analyze the data (significance level <0.05). Results: The mean blood glucose levels and diabetes distress before and after in the intervention group were 255.19 mg/dl, and 245.60 mg/dl (p-value >0.05); 2.46 and 2.01 (p-value 0.05). Conclusions: The diabetes-tailored intervention program is effective on decreasing blood glucose levels and diabetes distress, and showed a significant result to diabetes distress

Discovering elements and developing strategies to implement the tailored care education for patients with diabetes through a systematic review

[[abstract]]Background: The popular intervention in avoiding diabetes complications in several countries is health education. However, a tailored care education approach based on the phenotyping of patients abilities, preferences, cultural orientation is still unclear. Purpose: To discover elements and develop strategies to implement tailored care education for patients with diabetes through a systematic review. Methods: This two-stage systematic review was conducted. The first stage was primary search and assessed the quality of articles followed by discovering elements and developing strategies of tailored care education for patients with diabetes in the second stage. Results: This review included 44 out of 1421 articles that were published in English and focused to discuss on tailored care education for patients with diabetes. Self-management, patient preferences, patient value, interprofessional collaboration, tailored support, glycemic control, and patient centre were among the elements. These factors were utilized to develop seven step strategies for providing diabetes patients with tailored care education. Conclusion: Traditional clinical intervention, decision-making, and future research trends are predicted to be transformed into a personalized care approach. Establishing the effectiveness of tailored care education programs in reducing the risk of diabetes complications among diabetic patients is needed