Effectiveness of Tailored Care Intervention Program on Biochemical Outcomes of Patients with Diabetes in Indonesia: A Randomized Controlled Trial

Background: Although people with diabetes have common problems, their educational needs may be different and they all have the right to participate in the planning and implementation of individual or group health care programs. Meanwhile, there are no proper care interventions for diabetic patients in Indonesia. Therefore, the aim of this study was to evaluate the efficacy of a tailored care intervention program on some blood biochemical outcomes among Indonesian patients with diabetes. Methods: A randomized controlled trial (RCT) with pretest-posttest design recruited 163 subjects from January to April 2021 at Moyo Hilir and Moyo Hulu Primary Health Care Facilities, Sumbawa City, Indonesia. The subjects were randomly assigned to either intervention (n=80) or control (n=83) groups. The intervention group received a tailored care intervention program with seven elements that was implemented through (1) Brief deductive teaching (2) Self-management assessment (3) Brainstorming and support group and (4) Follow-up. The control group received regular education. The data were collected at baseline and then, three months after the intervention. The outcome measures were blood glucose levels, cholesterol, triglyceride and triglyceride glucose index. The IBM SPSS Statistics for Windows v. 20.0 was used for statistical analysis. The statistical methods included descriptive statistics (frequency distributions, percentages, means, and standard deviations) and inferential statistics (Chi-square, independent t-test and paired t-tests). The significance level was set at P < 0.05. Results: According to independent t-test, there were no significant differences in blood glucose levels of the groups before and after the intervention. There were also, no significant differences in cholesterol, triglyceride and triglyceride glucose index of the groups before the intervention but significant differences were seen after the intervention (P=0.000). However, the significance moved to negative direction. According to paired t-test, blood glucose level, triglyceride, and triglyceride glucose index increased in control group but decreased in intervention group, although it was not significant. On the other hand, cholesterol level increased in both intervention and control groups, which was not significant.  Conclusion: Although no significant findings were obtained, the results of glucose level, triglyceride and glucose triglyceride index of the intervention group were better than the control group, but not in terms of cholesterol level. Tailored care intervention programs have the potential to improve biochemical indicators, especially for blood glucose levels, triglycerides, and triglyceride glucose index; however, it seems that a follow-up study beyond three months is needed to be performed in the future.