Effectiveness of designated treatment partners among adult patients with diabetes mellitus type 2: A randomized controlled trial
- Author:
Sorrosa Rojim J.
- Publication Type:Journal Article
- MeSH:
DIABETES MELLITUS;
TREATMENT
- From:
The Filipino Family Physician
2010;48(2):58-70
- CountryPhilippines
- Language:English
-
Abstract:
Background: Diabetes is a life-long chronic illness. Management is geared towards controlling the blood sugar levels in order to avoid acute and chronic complications. However, adherence to medical and non-pharmacologic interventions is one of the many pressing problems of patients with Diabetes Mellitus Type 2.
Objectives: The study seeks to determine the effectiveness of designated treatment partners selected according to a doctor and a patient's preference in controlling the hemoglobin A lc levels (HbA lc) at values lesser than or equal to 6.5% among non-insulin treated diabetes patients.
Design, Setting and Patients: The study is an open-labeled randomized controlled trial conducted from January to June 2009 at the Family Medicine Clinic of the Philippine General Hospital. A total of 60 target subjects with uncontrolled Hemoglobin A 1 c (HbA 1 c) were recruited and enrolled in this investigation.
Intervention: The study subjects were randomized to two groups namely, treatment partners according to doctor's and patient's preference. These subjects were followed-up on the third and sixth month.
Main Outcome Measure: The primary outcome measure was targeted towards controlling the HbAlc levels to values equal to or less than 6.5% with a 0.6% difference between treatment arms.
Results and Discussion: The baseline sociodemographic and clinical characteristics were similar at the start of the study except for the duration of diabetes (P=0.04) and baseline systolic blood pressure (P=0.04). The mean scores for burden of illness, health perception, and perceived adherence factors were similar for both arms. The mean HbA lc scores for both groups were similar at baseline (8.41 v 7.89, P = 0.43). Results showed that the HbA lc levels of both groups were lower than the cut-off value of 6.5% after a six-month study period however, these differences were not statistically significant (p = 0.28) in between treatment groups. But using the general linear model to assess significance across the follow-up period, results of the study showed that the difference of HbA lc levels obtained after a six month follow-up compared to the baseline was statistically significant (P = 0.003). Majority of the chosen partners in both treatment arms are their spouses. It is postulated that marital adjustment and high levels of perceived intimacy could have facilitated a healthy adaptation to diabetes hence, achieving the target HbAlc levels across arms.
Conclusion: Selection of designated treatment partners according to a doctor's preference is unlikely to be effective over treatment partners selected according to a patient's preference.
