oa Evaluation of a Mobile Social Networking Application for Glycaemic Control and Diabetes Knowledge in Patients with Type 2 Diabetes: A Randomized Controlled Trial Using WhatsApp

Background and objectives

Diabetes mellitus is considered one of the most common chronic diseases affecting adult population worldwide, particularly the Middle East. According to recent statistics, Saudi Arabia is ranked as the seventh highest prevalence of diabetes in the world and the first highest prevalence in the MENA region with 3.8 million cases. In parallel, more than 60% of Saudi population is using the Internet and WhatsApp, which is considered the most popular mobile application in Saudi. The hypothesis in this study is that social network can play a significant role on managing the diabetes by promoting healthy-life behavior, providing education to increase the knowledge of diabetic patients, change bad habits, reduce the complications and improve life quality and the level of physical activity. The primary aim of this study is to evaluate the effect of using mobile technology (Whatsapp) for health care to improve the level of knowledge of diabetic patients and to control the level of glycated hemoglobin (HbA1C) along with enhancing their self-efficacy level.

Methodology

A randomized controlled trial on Type 2 diabetes patients was conducted. Ninety-two patients (Saudi, female, not pregnant) were selected at a Teaching Hospital in Al-Khobar, Eastern Province of Saudi Arabia. Diabetes knowledge test (DKT) and Diabetes Management Self-Efficacy Scale (DMSES) were recorded from all participants at the baseline and after the intervention by face-to-face interview. The Diabetic Knowledge Test (DKT) is a questionnaire of 24 items represents a test of general knowledge of diabetes. While the Dutch/US Diabetes Management Self-Efficacy Scale (DMSES) is a tool used to measure the patient's efficacy expectation for engaging in 20 self-management activities of Type 2 diabetes. HbA1C was also collected only at the enrollment for some participants from their medical records. The period of intervention was 8 weeks. During this period, free messages via Whatsapp were sent to the intervention group weekly, a message per week. While the control group followed their usual diabetes care. The messages were written in Arabic and have been reviewed by a specialist in diabetes. Its content was about general diabetes care knowledge; included diabetes signs and symptoms, pathophysiology, etiology, diet therapy, exercising, etc. The main educational goal was to improve the level of knowledge of diabetic patients.

Results

Chi-square test showed there were no significant differences between study groups in demographic or clinical characteristics. The results showed significant improvement in patients' knowledge and self-efficacy level (p <  0.001) when comparing the intervention group with the control group. The mean knowledge increased from 14.45 ±  2.38 to 21.28 ±  1.59 (mean ±  SD), and mean self-efficacy also increased from 6.65 ±  1.47 to 7.34 ±  1.26 (mean ±  SD).

Conclusion

There are very few studies in Saudi Arabia investigating the effectiveness of mobile technology in managing patients with diabetes. However, this study considered the first of its kind applied in Saudi Arabia demonstrates that mobile technology, specifically WhatsApp, can be an acceptable approach to improve the knowledge and disease-management in patients with Type 2 diabetes in Dammam region. In addition to provision of ongoing healthcare support to patients considering the progressively widespread use of Internet and mobile applications in Saudi Arabia.