Effect of using mobile phone communication in the management of Type 2 Diabetes Mellitus among adult patients attending Kitui County Referral Hospital, Kenya

Abstract

The incidence and prevalence of Diabetes Mellitus has been rising globally, Kenya included and it is estimated that by 2030, the number of cases will almost double. The current interventions focus mainly on group health talks, which are not individualized, and have limited influence on adherence to health seeking behavior, drugs, and diet. In addition, there is limited information on the effectiveness of using mobile phone communication in diabetes management. The aim of the study was to determine the effect of mobile phone communication in the management of T2DM among patients attending Kitui Referral Hospital. The study design was longitudinal with qualitative and quantitative components. Consecutive sampling was used where every eligible and consenting Type 2 Diabetes Mellitus (T2DM) patients that came to the hospital in the month of March and April 2017 were selected and assigned to the intervention and control group until the required number of subjects for the study were achieved. One hundred and thirty eight (138) respondents participated in the study; 67 in intervention group (IG) and 71 in the control group (CG). By use of the mobile phone, key nutrition messages on health seeking behavior, drug adherence and dietary practices were developed and sent to the IG for six months. Descriptive statistics were used in describing the socio demographic and economic characteristics, while inferential statistics included odds ratio and logistic regression analysis for morbidity, health seeking behavior, drug and dietary practices. Net Effect of Intervention (NEI) analysis was used to determine the impact of intervention with level of significance set at p<0.05. There was no significant difference in the socio-economic characteristics of the IG and the CG. The proportion of respondents with controlled blood pressure (BP) increased from 44.8% to 49.3% in IG compared to a decline from 53.5% to 47.9% in the CG after six months. The NEI was significant (p=0.046). The proportion of respondents who conducted self-monitoring of blood glucose (SMBG) increased from 32.8% to 41.8% in IG while it reduced from 39.4% to 31% in CG. The NEI was significant (p=0.047). The proportion of respondents who took their drugs at specific times increased from 58.2% to 74.6% in the intervention group (IG) compared to a decrease of 47.9% to 46.5% in the control group (CG). The NEI was significant (p=0.007). The proportion of respondents who followed a meal plan increased in intervention group (IG) from 47.8% to 59.7% compared to a decrease in CG from 49.3% to 45.1%. The NEI (16.1%) increase was statistically significant (p=0.021). The proportion of respondents with increased frequency of meals increased from 41.8 to 47.8% in the IG compared to a reduction in the CG from 52.1% to 45.1% after six months. The NEI (13%) increase was statistically significant (p=0.032). In conclusion, use of mobile phone communication improved adherence to key management practices in the management of T2DM. It is recommended that there should be increased use of mobile phone communication in the management of T2DM.