Effectiveness of a Health Behavior Change Promotion Program for Patients with Type 2 Diabetes on Glycated Hemoglobin Levels in Primary Care Units
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Abstract
Background: Type 2 diabetes is a major public health issue. Current management emphasizes promoting healthy behaviors through Diabetes Self-Management Education and Support (DSMES), which has been shown to reduce glycated hemoglobin (HbA1c) levels. However, primary care units in Thoen District have not yet systematically integrated DSMES. Consequently, Thoen Hospital developed the DSMES-based health behavior change promotion program.
Objective: To evaluate the effectiveness of the health behavior change promotion program among type 2 diabetes patients on HbA1c levels, antidiabetic medication use, and antidiabetic medication costs.
Materials and Methods: A pre-experimental one-group pretest-posttest study was conducted using retrospective data from patients with type 2 diabetes who participated in the program at 19 primary care units in Thoen District, Lampang Province, from April to July 2024. Baseline and 3-month follow-up data were analyzed using paired
t-test and Wilcoxon signed-rank test.
Results: A total of 265 patients participated, of whom 196 (74.0%) were female. The mean age was 57.5 ± 8.7 years, and the median duration of diabetes was 4.1 years. After the program participation, the mean HbA1c decreased from 7.6 ± 1.6% to 7.4 ± 1.0% (p=0.016). Patients with baseline HbA1c of 8.1–9.9% and ≥10% showed significantly reductions of HbA1c (-0.9% and -2.1%, respectively, p<0.001). Most patients maintained the same antidiabetic medication regimen (85.7%), while 11.7% reduced medications and 2.6% required additional medications. Median antidiabetic medication cost decreased from 15.90 to 12.60 Thai baht/person/month (p < 0.001).
Conclusion: The health behavior change promotion program effectively reduced HbA1c, especially in patients with baseline HbA1c > 8.0%. Most participants maintained their previous dosages of antidiabetic medications, while the cost of antidiabetic drugs showed a slight decrease.
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บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
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