Development of Diabetes Telephone-Linked Care System for Self-Management Support and Acceptability Test among Type 2 Diabetic Patients
Nittayawan Kulnawan MS*, Wiroj Jiamjarasrangsi MD, PhD**, Sompong Suwanwalaikorn MD***, Tanattha Kittisopee PhD****, Kulwara Meksawan PhD*****, Natthanan Thadpitakkul PhD*****, Kattiya Mongkung PharmD*
Affiliation : * Faculty of Pharmacy, Huacheiw Chalermphrakiet University, Samutprakan, Thailand ** Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand *** Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand **** Department of Social Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand ***** Human Voice Synthesis Laboratory, the National Electronic and Computer Technology of Thailand, Pathumthani, Thailand
Objective : Develop the diabetes telephone-linked care system for self-management support and test acceptability in terms of
system uses, satisfaction and perception of easiness, helpfulness, and emotion with the system.
Material and Method: The automated telephone system with diabetes knowledge interactive voice response (IVR) subsystem
was developed to provide diversified curriculum arrangement including general knowledge module (Knowledge IVR, suggestive
segment module (Suggestive IVR) and 10 QA sets for assessment with tailored information feedback (QA IVR). The system
could deliver 1,120 messages over five weeks among 112 intervened participants of the on-going randomized controlled trial
on its impact on glycemic control. The system analyzed the level of completed responses.
Results : Overall, 25.9% of the responses were intermittent, 46.4% had consistent adherences, 14.3% were poor responses,
and 13.4% were non-responses. The total time use of the system, among 97/112 participants, was 6,189 minutes (mean 63.80,
SD 26.63). The degree of call completeness did not vary according to the participant’s socio-economic status, glycemic level,
or years of diabetes diagnosis. The satisfaction of participants to the program was done by interviewed by telephone among
95 of 112 participants. Most study participants reported that they were very/moderately satisfied with the program (89.5%)
regarding its usefulness and helpfulness on awareness, understanding and reminding behavior change attempts. In all,
95.8% of the responders planned to participate in the next program. Duration of time uses of the TLC was significantly
correlated to the total scores of helpfulness and of emotion (p < 0.01; r = 0.38 and 0.31 respectively).
Conclusion : This prototype of diabetes telephone-linked care for Thai diabetes is a step forward in response to diabetes self-
management education need. Further studies are needed about its efficacies on diabetes self-management improvement and
glycemic control, as well as its cost-effectiveness.
Keywords : Diabetes, Telephone-linked care, Self-management support, Interactive voice response, Automated telephone, Diabetes self-management education
