Effects of the Case Management With Community Support Program on Health Behaviors and Outcomes in Thai Buddhist Monks With Type 2 Diabetes and Early-stage Chronic Kidney Disease

Abstract

Background: Patient engagement and community support are vital for promoting self-care in monks with early-stage chronic kidney disease (CKD). This study investigated the impact of an 18-week Case Management with Community Support Program (CMCSP) on self-care activities and health outcomes (hemoglobin A1c, HbA1c), blood pressure, and estimated glomerular filtration rate (eGFR) in Thai Buddhist monks with type 2 diabetes mellitus (T2DM) and CKD. Methods: A Randomized Controlled Trial (RCT) with pretest and post-test measures was employed. Eighty-two monks with T2DM and stage 1e2 CKD were recruited from 33 subdistricts in Thailand and randomly assigned into experimental (n = 41) and control (n = 41) groups. The experimental group received CMCSP and usual care, while the control group received only usual care. The CMSCP included self-management skills training sessions, follow-ups, and community support. Outcomes were assessed at baseline and 18 weeks post-enrollment. Research tools included Brief cognitive screening, the Summary Self-Care Activities questionnaire, and clinical measures. Results: Significant differences were found in health outcomes between groups (F = 19.857, p < 0.001), with large effect sizes for self-care activities (hp² = 0.487), HbA1c (hp² = 0.155), and eGFR (hp² = 0.208). Conclusions: The CMCSP led to significant improvements in self-care and health outcomes, suggesting that nurse case managers should implement this program to support monks with T2DM and early-stage CKD.