Effect of the personalized patient engagement plan on diabetes management in patients with type 2 diabetes

This randomized controlled study aimed to determine the effect of the Personalized Patient Engagement Plan (PHEinAction) on treatment adherence, self-efficacy, and patient engagement in individuals with type 2 diabetes. Initially, Turkish adaptation, including language and content validity, and the pilot implementation were performed. Then, the effect of the PHEinAction on diabetes management was examined in a pre-test-post-test parallel-group randomized controlled trial with 51 participants in the Endocrine Outpatient Clinic of Hacettepe University Adult Hospital between 26 January-29 November 2021. Data were collected with the Health Literacy Scale, Type 2 DM Treatment Patient Compliance Scale, Diabetes Management Self-Efficacy Scale, and Patient Health Engagement Scale. Individuals who met the inclusion criteria were randomly assigned to the intervention (n: 24) and control (n: 27) groups. The PHEinAction included two face-to-face interview sessions at four-week intervals, telephone counseling two weeks after the first session, and home-based written exercises designed based on the specific features of each engagement phase that participants administered during the four weeks. In the first session with the intervention group, participants' illness experience was collected, the concept of patient engagement was clarified, specific care goals were identified, and home-based exercises were introduced. In the second session, the new experiences of the individuals in the four weeks and the home-based exercises were discussed, the care goals were revised by giving positive feedback on the progress made, and the individuals were encouraged to continue the engagement plan. Ten-minute telephone counseling was conducted to receive feedback on their progress/challenges in implementing the home-based exercises and provide support for motivation. Pre-test-post-tests were administered to the intervention group before the first session and after the second session. Participants in the control group did not receive any intervention other than the routine controls applied in the outpatient clinic, and the individuals were evaluated in the first and fourth weeks. As a result, treatment compliance, self-efficacy, and patient engagement levels of the participants in the intervention group increased significantly. According to these results, it is recommended to combine PHEinAction with diabetes self-management education and integrating into patient follow-up in outpatient clinics.