The efficacy of an EMR-enabled text messaging system to the expanded health beliefs, diabetes care profile and HbA1c of diabetes mellitus patients

Abstract As diabetes mellitus (DM) becomes a global emergency, there is a need to explore novel interventions to address problems in self – management. Literature agree in the potential of mobile phones to carry-out self-care for a wide-array of disease conditions. Diabetes Self – Management Support and Education Through Text – Messaging (DSMSET) is a low-cost, two-way text messaging system designed to deliver self - help, educational messages based on the nine (9) dimensions of health management. DSMSET serves as a plugin to SHINE OS+, an open – source electronic medical record (EMR) system. The research is also based on the Expanded Health Belief Model and explores the efficacy of SMS in improving Expanded Health Beliefs, Diabetes Care Profile and in decreasing HbA1C of adult patients with DM. A two-arm, randomized controlled trial, a total of 122 eligible subjects from UERM PO Domingo OPD Services Department of Medicine and Sweet Diabetics Club based in CHAMP Wellness Clinic were enrolled. Using simple table random digits, subjects were divided equally to trial arms between SMS and non – SMS. The SMS group received DSMSET intervention for 90 days and were required to reply pre-set codes. Both groups answered two sets of survey questionnaires. Patient profile data including demographics for both groups were collected using SHINE OS+ before and after 90-day period. At follow-up, 110 participants were distributed equally and were subjected to analysis with descriptive and inferential statistics using STATA15 and SPSS23. Results show that Total Expanded Health Belief Scores (8 Constructs), Diabetes Care Profile Score, Likelihood to Take Action Score of the SMS group increased compared to the non-SMS group. Combined Expanded Health Belief Scores also showed modest improvement. However, SMS group posted relatively unchanged HbA1c levels while the non-SMS group had increased HbA1c on average.

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