Introduction:
Noncommunicable diseases (NCDs), particularly diabetes and chronic kidney diseases, pose a significant health burden in Thailand, especially among socioeconomically disadvantaged populations. The existing primary health care system in Thailand faces challenges in providing optimal care for NCDs due to an inadequate primary care. This paper presents the design and baseline characteristics for a study evaluating a technology-based solution to enhance NCD management through task-sharing among non-physician health care workers in rural Thailand.
Methods:
A pragmatic, type 2 hybrid effectiveness or implementation, parallel-group cluster randomized controlled trial of 12 months duration involving 51 sub-district health offices in rural communities of Kamphaeng Phet province, Thailand, is currently being conducted. The intervention arm utilizes a technology enabled program (SMARThealth Diabetes), including workforce restructuring, clinical decision support system, and continuous performance monitoring, while the control arm is continuing with usual practice. Baseline characteristics are presented by comparing sociodemographic characteristics and primary as well as secondary outcomes for the trial for intervention and control groups. The trial is registered under The Thai Clinical Trials Registry TCTR20200322006; The primary outcome measure will be the change in mean HbA1C measured at randomization and 12 months from randomization, between the intervention and control clusters.
Results:
The data collection commenced in November 2022. Among 1593 enrolled, baseline characteristics were comparable between the intervention and control groups. The intervention group had a lower mean BMI (25 ±8 versus 26 ± 4.6), a higher waist-to-hip ratio (0.98 ± 0.3 versus 0.89 (±0.1) and a lower eGFR (85 ± 13 versus 98 ± 16). The mean HbA1c was similar between the groups, with 7.3 (± 1.4) in the intervention group and 7.2 (± 1.4) in the control group.
Conclusions:
Baseline characteristics were comparable for intervention and control groups. The trial will explore a novel digital health intervention to enhance diabetes management in rural Thailand, providing insights for improving NCD care in low-resource settings globally.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.