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Virtual training sessions involving health literacy-based, education improved quality of life and treatment adherence among patients with type 2 diabetes.

Elevated risk for complications, increased rate of hospitalization, higher healthcare costs, and death are a few of the consequences associated with neglecting treatment as a patient with type 2 diabetes (T2D). Furthermore, the burden of care, as well as disease complications, can have an adverse effect on a patient’s QOL.

Meimanat Hosseini, PhD, and colleagues developed a classic experimental study to determine whether increased health literacy improves QOL and treatment adherence in patients with T2D. The results were published in Scientific Reports.

The 94 patients with T2D identified for inclusion in the study were cared for by a health center in Hashtgerd, Iran. They were randomly divided into the intervention (n=47) and control (n=47) cohorts. The mean age of the intervention cohort was 49.66 (standard deviation [SD] ±7.58) and 47.53 (SD ±8.64) in the non-intervention cohort.

The Educational Intervention

The intervention cohort received five 80- to 90-minute virtual class sessions consisting of vetted, scientifically sound information on T2D. These educational sessions were held over 5 weeks. The aim was to improve the viewer’s health literacy regarding T2D.

The educational sessions were structured as follows:

• A specific weekday was chosen for the training session, and all respondents attended online at the appointed time.
• Each session’s content was provided as a video file 1 week in advance for respondents to watch and prepare questions.
• At the start of the session, a researcher summarized the training content and highlighted key points using audio files, images, and short videos.
• A group Q&A session followed to address respondents’ questions.
• To implement the teach-back method, two to three respondents were randomly selected to share their impressions as an audio file after each educational material.
• After each session, all respondents submitted a 1- to 2-minute audio file with their opinions and key takeaways.
• Health literacy strategies and tools were used to create training materials, including videos, images, and printed media (eg, pamphlets), which were provided at the end of the intervention.

Assessment Tools

The participants’ QOL was assessed using the diabetes QOL-brief clinical inventory (DQOL-BCI). This tool consists of 15 items to gauge care behavior satisfaction and disease control; scores range from 15 to 75, with a higher score indicating improved QOL.

Treatment adherence was assessed using Mondanloo’s questionnaire of treatment adherence. Items targeted in the questions include commitment to treatment, active participation, willingness to adapt to treatment, adherence, and ability to incorporate treatment strategies into daily living. Scores range from 0% to 100%, with a higher score indicating good adherence.

At the start of the study, the intervention cohort had a mean (± SD) baseline score for QOL of 53.21 (± 7.60), and the control cohort’s mean baseline score was 51.87 (± 9.47). After intervention, the intervention cohort reached a mean score of 55.28 (± 6.87). After the study, the control cohort reached a score of 54.41 (± 8.89). The researchers noted that the mean difference before and after the examination period was not statistically significant in this group (P=0.73). In comparing the mean QOL scores between the control and intervention cohorts, neither the baseline scores (P=0.57) nor the scores recorded two months after the intervention period (P=0.71) showed a statistically significant difference.

Regarding treatment adherence, the mean baseline score was 69.31 (± 5.32) in the intervention group; after the two-month examination period, the intervention cohort reached a mean score of 75.95 (± 7.68). The mean baseline score of treatment adherence in the control cohort was 69.86 (± 5.51); after the 2-month examination period, the mean score reached 70.59 (± 5.21).  The researchers noted a statistically significant difference (P˂0.001) between the two cohorts in these post 2-month scores.

“Given the results of the current study and other investigated studies, it can be said that holding training sessions for patients with type 2 diabetes is effective in promoting their QOL,” Dr. Hosseini and colleagues concluded. “The findings of this study can help clinicians make decisions and choose effective teaching methods for patients with type 2 diabetes to improve their QOL and accept the treatment regimen.