Comparison of Clinical Outcomes between Home Ward Care Involving Family and Community Participation and Usual Care among Patients with Poorly Controlled Type 2 Diabetes Mellitus in Khiri Mat District, Sukhothai Province

Abstract

     This two-group quasi-experimental study with a pretest–posttest design aimed to compare clinical outcomes between home ward care involving family and community participation and usual care among patients with poorly controlled type 2 diabetes mellitus in Khiri Mat District, Sukhothai Province. Participants were purposively selected and classified according to the care they actually received. The analysis included 152 patients, with 76 in the experimental group and 76 in the comparison group. The experimental group received home ward care from a multidisciplinary team, incorporating self-monitoring of blood glucose, daily health reporting, and participation by family members, caregivers, and village health volunteers. The comparison group received usual care at the diabetes clinic. Data were collected using an enrollment form and a follow-up form to assess clinical outcomes at baseline and at the 6-month follow-up. Data were analyzed using descriptive statistics, the chi-square test, Fisher’s exact test, the independent samples t-test, and the paired samples t-test.

     The findings showed that 1) baseline characteristics did not differ between the experimental and comparison groups; 2) before the intervention, mean hemoglobin A1c levels, numbers of metformin, glipizide, and pioglitazone tablets per day, doses of premixed human insulin 30/70, blood lipid levels, systolic blood pressure, and diastolic blood pressure did not differ between the groups. After the intervention, the experimental group had a lower mean hemoglobin A1c level than the comparison group, with statistical significance at the 0.05 level. Mean numbers of metformin, glipizide, and pioglitazone tablets per day, doses of premixed human insulin 30/70, blood lipid levels, systolic blood pressure, and diastolic blood pressure did not differ between the groups; and 3) after the intervention, the experimental group had lower mean hemoglobin A1c levels, numbers of metformin tablets per day, systolic blood pressure, and diastolic blood pressure than before the intervention, with statistical significance at the 0.05 level. The comparison group had lower mean hemoglobin A1c levels and diastolic blood pressure, and a higher mean number of glipizide tablets per day than before the intervention, with statistical significance at the 0.05 level.