Nurse-Led Mobile Phone Intervention to Promote Self-Management in Type 2 Diabetes in Ghana: A Randomized Controlled Trial

PURPOSE: The purpose of the study was to test the effectiveness of a nurse-led mobile phone intervention (NMPI) on glycemic variability and self-management among people living with type 2 diabetes (T2DM) in Ghana.

METHODS: In this randomized controlled trial, the intervention group received a 3-month NMPI program plus standard care, and the control group received standard care alone in a tertiary health care setting. Ninety-eight participants (baseline A1C > 7%) were randomized 1:1 to either NMPI or standard care group. The primary study outcomes were changes in A1C testing and self-management assessed using the Summary of Diabetes Self-Care Activities tool at baseline and end of the study.

RESULTS: The intervention group had statistically significant improvement in their mean A1C level from baseline to the end of the study. In comparison, the control group also had improvement in their mean A1C level but was not statistically significant. Consistently, the intervention participants had better statistically significant improvements in self-management behaviors than the control group. There was a medium, negative correlation between A1C changes and overall self-care changes for the intervention group, whereas that of the control group was smaller.

CONCLUSIONS: Study findings have shown that a tailored NMPI program in addition to standard care could improve glycemic variability and self-management among people living with poorly managed T2DM in Ghana better than standard care alone.