Arabic mHealth and Pharmacist Teleconsultation for Medication Adherence, Self-Care, and Quality of Life in Iraqi Adults with Type 2 Diabetes: A Randomized Controlled Trial
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Objective: This study evaluated the effectiveness of an Arabic mobile health application combined with pharmacist-led telephone and video consultations on medication adherence, self-care behaviors, and quality of life among adults with type 2 diabetes in Iraq.
Methods and Materials: This parallel-group randomized controlled trial was conducted at the Endocrinology and Diabetes Center in Baghdad, Iraq. A total of 146 adults with type 2 diabetes completed the 6-month study and were included in the analysis: intervention group (n = 76) and standard-care control group (n = 70). Participants were stratified by baseline HbA1c and randomized. The intervention group received standard care plus the Arabic Edarat Alsukari mHealth application and biweekly pharmacist-led telephone or video consultations. Outcomes were assessed using the Iraqi Anti-Diabetic Medication Adherence Scale, Diabetic Self-Care Knowledge and Practice Scale, and Quality of Life Scale for Iraqi Diabetics.
Findings: At 6 months, medication adherence was significantly higher in the intervention group than in the control group (16.32 ± 1.83 vs. 14.10 ± 1.90, p < 0.001, d = 1.19). Total self-care also improved significantly (17.23 ± 2.08 vs. 12.10 ± 3.90, p < 0.001, d = 1.63), especially foot care (3.20 ± 0.95 vs. 1.20 ± 1.30, p < 0.001, d = 1.74). Dietary self-care did not differ significantly (p = 0.720). Quality of life was higher in the intervention group (15.79 ± 2.75 vs. 14.10 ± 3.10, p < 0.001), with lower disease burden (3.08 ± 1.53 vs. 4.15 ± 1.80, p = 0.003).
Conclusion: The Arabic mHealth and pharmacist teleconsultation intervention significantly improved adherence, self-care, and quality of life, but not dietary behavior.
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Al‐Rubeaan, K., Al‐Manaa, H. A., Khoja, T. A., Ahmad, N. A., Al‐Sharqawi, A. H., Siddiqui, K., Alnaqeb, D., Aburisheh, K. H., Youssef, A. M., & Al‐Batel, A. (2015). Epidemiology of abnormal glucose metabolism in a country facing its epidemic: SAUDI‐DM study: 一个国家面临的糖代谢异常的流行病学研究: SAUDI‐DM 研究. Journal of diabetes, 7(5), 622-632. https://doi.org/10.1111/1753-0407.12224
Alsswey, A., Al-Samarraie, H., & Bervell, B. (2021). mHealth technology utilization in the Arab world: A systematic review of systems, usage, and challenges. Health and Technology, 11(4), 895-907. https://doi.org/10.1007/s12553-021-00549-3
Cutler, R. L., Fernández-Llimos, F., Frommer, M., Benrimoj, C., & García-Cárdenas, V. (2018). Economic impact of medication non-adherence by disease groups: a systematic review. BMJ open, 8(1), e016982. https://doi.org/10.1136/bmjopen-2017-016982
Diabetes, A. (2015). International diabetes federation. IDF Diabetes Atlas, 7th edn. Brussels, Belgium: International Diabetes Federation, 33(2), 92135-92138. https://www.scirp.org/reference/ReferencesPapers?ReferenceID=2085700
Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., Patel, V., & Haines, A. (2013). The effectiveness of mobile-health technology-based health behavior change or disease management interventions for health care consumers: a systematic review. PLoS medicine, 10(1), e1001362. https://doi.org/10.1371/journal.pmed.1001362
Iribarren, S. J., Cato, K., Falzon, L., & Stone, P. W. (2017). What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions. PloS one, 12(2), e0170581. https://doi.org/10.1371/journal.pone.0170581
Mansour, A. A. (2009). Chronic complications of diabetes in Iraq: experience from southern Iraq. Clinical medicine. Endocrinology and diabetes, 2, CMED. S3657. https://doi.org/10.4137/CMED.S3657
Mikhael, E. M., Hassali, M. A., Hussain, S. A., & Shawky, N. (2018). Self-management knowledge and practice of type 2 diabetes mellitus patients in Baghdad, Iraq: a qualitative study. Diabetes, Metabolic Syndrome and Obesity, 1-17. https://doi.org/10.2147/DMSO.S183776
Mikhael, E. M., Hassali, M. A., Hussain, S. A., & Shawky, N. (2020). The development and validation of quality of life scale for Iraqi patients with type 2 diabetes mellitus. Journal of Pharmacy and Bioallied Sciences, 12(3), 262-268. https://doi.org/10.4103/jpbs.JPBS_190_19
Mikhael, E. M., Hussain, S. A., Shawky, N., & Hassali, M. A. (2019). Validity and reliability of anti-diabetic medication adherence scale among patients with diabetes in Baghdad, Iraq: a pilot study. BMJ Open Diabetes Research & Care, 7(1). https://doi.org/10.1136/bmjdrc-2019-000658
Musaiger, A. (2012). The Food Dome: Dietary Guidelines for Arab Countries. Nutrición hospitalaria, 27(1), 109-115. https://doi.org/10.1155/2012/905303
Othman, Z. K., Musa, S. S., Ahmed, M. M., Okesanya, O. J., Alhammadi, O. A. S., & Eliseo III, D. L.-P. (2025). Digital health technologies in the Kurdistan region of Iraq: a narrative review of enhancing healthcare accessibility and quality. Discover Public Health, 22(1), 227. https://doi.org/10.1186/s12982-025-00648-w
Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., & Jackson, R. A. (2005). Assessing psychosocial distress in diabetes: development of the Diabetes Distress Scale. Diabetes care, 28(3), 626-631. https://doi.org/10.2337/diacare.28.3.626
Sabaté, E. (2003). Adherence to long-term therapies: evidence for action. World Health Organization. https://www.paho.org/sites/default/files/WHO-Adherence-Long-Term-Therapies-Eng-2003.pdf
Schlomann, A., Seifert, A., Zank, S., & Rietz, C. (2020). Assistive technology and mobile ICT usage among oldest-old cohorts: comparison of the oldest-old in private homes and in long-term care facilities. Research on aging, 42(5-6), 163-173. https://doi.org/10.1177/0164027520911286
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