Period: 2015-2018

Researchers: Andrea Beratarrechea, Vilma Irazola, Silvana Grosso, Analía Nejamis, Marilina Santero, Meliza Zamaniego, Patricia Chamorro, Alicia Pereira

Goal

To evaluate the feasibility of implementing a mobile application for health providers that integrates a diabetes registry associated with a SATDC for the care of people with diabetes in the field of primary health care in the province of Corrientes, as well as the perceptions of the health team on the implementation and integration of this type of ICT at the first level for the care of people with diabetes. To also evaluate participants' perceptions of educational text messages and reminders received to improve diabetes control. Finally, evaluate whether the implementation of these interventions improves the quality of care indicators in the diabetic population served in primary health care centers.

Summary

The project seeks to strengthen health services in primary care centers (CAPS) with the aim of providing high-quality care and improving coverage for patients with diabetes who live in low-income areas in the province of Corrientes, Argentina.

The objectives of this project are:
1. Train the primary care team for the implementation of the Diabetes Clinical Practice Guidelines (GPCD) and diabetes education strategies.
2. Implement a Diabetes Registry that allows the identification and monitoring of the population and a strategy based on Mobile Health to improve the assistance and monitoring of the diabetic patient population in the CAPS.
Target population:
Adults diagnosed with diabetes who receive care in CAPS located in low-income areas of the province of Corrientes.
Planned Activities to achieve objectives
To meet the stated objectives, the following activities will be developed:
• Training workshops for primary care doctors and nurses for the implementation of the GPCD.
• Training workshops for health workers to provide diabetes education, facilitate behavior change towards healthier lifestyles, and serve as a link between the community and CAPS.
• Diabetes education workshops aimed at health professionals who make up the primary care team.
• Training workshops for people from the community or peers.
• The implementation of an Information and Communication System (SIC) using an application on a tablet that will allow the collection of data from diabetic patients belonging to the CAPS reference area with information related to contact information, diagnosis, complications and treatment. that diabetic patients receive. In this way, a registry of diabetics will be created that will provide information for the follow-up and monitoring of this population as well as for micromanagement in the CAPS.
• The implementation of a Mobile Health strategy through the installation of a web platform that allows the sending of educational SMS and reminders to improve consultation rates at health centers, compliance with recommended practices, adherence to treatments and monitoring the population of each CAPS.

Expected results of the Project in the Health System:

• 20 CAPS located in low-income areas will be strengthened.
• 155 primary care doctors and nurses will be trained in diabetes prevention and management, as well as self-care education.
• 107 health agents and peers will be trained to provide education and support to patients with diabetes and their families.
• 100 diabetes educators will be trained and certified.
• 50 peers trained to provide self-care education.
• Manuals will be generated and delivered with the content of the workshops and to health professionals.
• 40 self-care education workshops will be implemented during the implementation of the project.
• A diabetic patient registry and web-based platform for providing mHealth services will be installed and operational in the selected CAPS.
• 80% of the diabetic population living in the CAPS reference area will be captured and included in the registry.
• 70% of the identified diabetic population will be reached through Mobile Health interventions (text messages).
• Posters and posters will be produced and distributed with educational messages on diabetes prevention and diagnosis produced and distributed in the CAPS and will be posted on the website of the Ministry of Public Health.

Expected results of the project in the target population:

• A 50% increase in the number of diabetic patients with an annual HbA1c, eye and foot exam.
• A 50% reduction in the number of diabetic patients with poor metabolic control (HbA1c˃9%).
• A 30% increase in the number of diabetic patients with controlled blood pressure (<140/90 mmHg).
• A 50% increase in the number of diabetic patients with follow-up visits to CAPS.

Institutional Framework

• Institute of Clinical and Health Effectiveness (Applicant Institution)
• Ministry of Public Health of Corrientes. (Collaborating institution)

Study design

Quasi-experimental study

Financing

World Diabetes Foundation