A Nurse-Led Intervention Program Using the LINE Official Account (OA) Application to Improve Self-Care and Clinical Outcomes in Patients With Diabetes and Comorbidities

Abstract

Purpose: The purpose of the study was to evaluate the effectiveness of a nurse-led intervention via the LINE Official Account (OA) application on knowledge, self-care, and clinical outcomes in patients with type 2 diabetes and comorbidities in Thailand. Methods: A cluster 2-arm randomized controlled trial with assessments at baseline, 6 weeks, and 12 weeks was conducted in 2 noncommunicable disease clinics between October 2023 and March 2024. A total of 108 participants were recruited and randomly assigned to either the intervention group (n = 55) or control group (n = 53). Using Orem’s Self-Care Deficit Nursing Theory as a conceptual framework, the 12-week intervention included knowledge and behavioral assessment, health education support, and practicing reminder via the LINE OA application. The control group received usual care. Outcomes included knowledge, self-care agency, self-care behaviors, A1C, blood pressure, and microalbuminuria (MAU). Data were analyzed using t-tests, repeated measures analysis of variance, and Cohen’s d. Results: Compared to the control group, at 6 and 12 weeks, participants in the intervention group demonstrated significant improvements in knowledge, self-care agency, and self-care. Clinically significant changes in A1C, blood pressure, and MAU were observed at 12 weeks in the intervention group. Conclusion: The study findings highlight the effectiveness of the nurse-led intervention via LINE OA application in knowledge, self-care, MAU, and A1C improvement. Extended study duration is recommended to assess sustainability for the future study.