Effects of a family-doctor-led community intervention model on self-management and medication taking in patients with type 2 diabetes mellitus: a randomized controlled trial

The purpose of this study is to address the serious challenges China faces in diabetes prevention and treatment. Amidst the rapid global increase in diabetes prevalence, China now has the largest number of diabetes patients worldwide. To address this problem, the present study aimed to evaluate a family doctor-led community intervention model to provide an effective and sustainable solution for diabetes management. Using a randomized controlled trial design in this 3-month intervention study (conducted from March to June 2023), 180 participants were divided into an intervention and control group. The control group received only routine diabetes management; the intervention group received additional services provided by a family doctor, including a professional treatment plan, diabetes education, medication reminders, personalized follow-up, and guidance assessment. Differential analysis and multiple factor linear regression analysis were used to evaluate the effects of intervention measures in patients with type 2 diabetes mellitus. After intervention, the intervention group demonstrated a significant decrease in glycated hemoglobin levels (t = 8.184, P < 0.001), as well as significant improvements in knowledge, attitude, behavior, and medication taking scores (P < 0.001). Further studies showed that improvements in knowledge (β = 0.720, P < 0.001), attitude (β = 0.135, P < 0.001), behavior (β = 0.526, P < 0.001), and medication taking (β = 0.205, P < 0.001) all contributed to the enhancement of self-management capabilities in patients with type 2 diabetes mellitus, jointly accounting for 99.9% of the improvement in overall self-management (adjusted R² = 0.999). Implementing a comprehensive intervention led by family doctors for patients with type 2 diabetes mellitus in the community significantly improved patients’ key physiological indicators and enhanced various aspects of patients’ knowledge, attitude, behavior and medication taking. Chinese Clinical Trial Registry, ChiCTR2400079653, retrospectively registered on 09 January 2024.