Effects of the People-Centered Healthcare Integration Program by the Family Care Team on HbA1C among Uncontrolled Type-2 Diabetes Mellitus Patients in the Primary Healthcare Unit, Ratchaburi Hospital
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Abstract
ABSTRACT
Background: Type 2 diabetes mellitus is a major global public health problem. Uncontrolled blood glucose leads to chronic complications, and integrated care delivered by a family care team is a promising approach to diabetes management at the primary care level. This study examined the effects of a healthcare integration program centered around family care teams on HbA1C levels.
Design: This was a quasi-experimental study with a two-group repeated measures design
Methods: A sample of 80 patients with uncontrolled type 2 diabetes who were registered for treatment at the Primary Healthcare Unit of Ratchaburi Hospital were included. These patients had HbA1c levels greater than 7% for those aged 18 to 65 and more significant than 7.5% for those older than 65. Participants were assigned using multistage sampling into an experimental group (n = 40) and a control group (n = 40). The experimental group received a healthcare integration program focused on HbA1C levels, while the control group received usual care and a DM self-care booklet. The study measured outcomes at two time points: baseline and three months after follow-up. Data were analyzed using descriptive statistics, independent t-tests, and paired t-tests.
Results: Mean HbA1c and fasting blood sugar (FBS) levels significantly differed between the experimental and control groups after a three-month follow-up (p < 0.001). Additionally, mean scores for diabetes knowledge, attitudes toward diabetes, and self-care behaviors significantly differed between the experimental and control groups after a three-month follow-up (p < 0.001). Within the experimental group, mean HbA1c levels and fasting blood glucose levels significantly decreased post-intervention (p < 0.001), while diabetes knowledge, attitudes, and self-care behaviors significantly improved (p < 0.001).
Conclusions: The people-centered integrated care program delivered by a family care team effectively reduced HbA1C among uncontrolled type-2 diabetes mellitus patients. These results indicate the program’s suitability for diabetes management within primary healthcare units and recommend piloting the program in other units with similar contexts.
Keywords: type 2 diabetes mellitus, HbA1c, integrated health care, family medicine practice
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