Telenursing Health Education and Lifestyle Modification among Diabetic Patients in Bangladesh: A Pilot Study with a Quasi-experimental Pre-and Post-Intervention Design (Preprint)
Authors: Moriyama Michiko , Huq K. A. T. M. Ehsanul , Mondol Lucy , Mita Akhi Roy , Nahar Niru Shamsun 
Published: February 2025

BACKGROUND

Background: The global burden of chronic diseases is increasing and becoming a public health issue throughout the world. The use of telenursing is increasing significantly during and after the COVID-19 pandemic to treat and prevent chronic diseases. Telenursing is growing in many countries to reduce health care costs, increase the number of aging and chronically ill populations, and increase health care coverage to distant, rural, small or sporadically populated regions. Among its many benefits, telenursing may help to solve increasing shortages of nurses; reduce distances, save travel time, and keep patients out of hospital.

OBJECTIVE

Objective: The objective of this study is to apply the self-management telenursing program and telenursing system developed by the researchers to Bangladesh and to evaluate its feasibility and efficacy (improved diabetes control in participants).

METHODS

Methods: This is a pilot, quasi-experimental pre-and post-intervention study. Diabetes patients who will attend the Grameen Primary Health Care Centers (PHCs) in Bangladesh will be enrolled between September 2024 and August 2025. We include patients who have been diagnosed with type 2 diabetes, both sexes, ages above 18-75 years old, all types of treatment and are willing to participate/give us consent. We exclude patients who have been diagnosed with gestational diabetes, diabetes as a secondary cause, complication of CKD stage 5, HbA1c is less than 7.0% for the past 1 year with CKD stage 1 or 2, no complications or complications with good control, having enough knowledge (had education before) and implemented good practice regarding diabetes management assessed by the research nurses, and disabled persons who need other person’s support for daily living. The sample size was calculated and found 70. Patients who meet the eligibility criteria will be introduced by physicians at the PHCs, and the nurses will contact them at the PHCs. Written informed consent (ICFs) will be obtained from all the participants. The outcome of this study is to evaluate the effects of telenursing intervention by controlling HbA1c. Protocols including ICFs got approval from the National Research Ethics Committee of Bangladesh Medical Research Council (BMRC/NREC/2022-2025/336) on September 08, 2024.

RESULTS

The project was funded in 2024. The enrollment of the participants was started on October 26, 2024 and required sample (n=70) enrollment was completed on February 2025. Data analysis will be started after completion of data collection and results will be expected to be submitted for publication in 2026.

CONCLUSIONS

Conclusions: Diabetic patients will acquire disease-specific management skills. Setting goals and monitoring them ensures the continuation of the desired behavior and gives the patients control over their lifestyle. After developing self-management skills, patients assess their lab data and lifestyles including diet and understand their condition so that they can work with their physiological data by acquiring knowledge of both the disease and self-care. By making self-supported decisions, the patients will be able to manage their diet, exercise and medication.

CLINICALTRIAL

ClinicalTrials.gov NCT06632652