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. 2023 Oct 24;2023(10):CD014722. doi: 10.1002/14651858.CD014722.pub2

Chew 2018.

Study characteristics
Methods Study design: cluster‐RCT
Duration of study: the study was conducted from April 2016 to February 2018.
Country: Malaysia
Income classification: upper‐middle‐income country from 2016 to 2018
Geographical scope: not specified
Healthcare setting: 10 public health clinics in Malaysia
Participants 1. Age: mean (SD) age: 55.6 (10.8)
2. Gender: both
3. Socioeconomic background: not specified
4. Educational background: not specified
Inclusion criteria:
a. Malay individuals;
b. aged ≥ 18 years;
c. diagnosed with type 2 diabetes for at least 2 years and having regular follow‐up;
d. presenting with a mean score ≥ 3 on the 17‐item Diabetes Distress Scale (DDS‐17);
e. with either HbA1c ≥ 64 mmol/mol (8.0%), blood pressure ≥ 140/90 mmHg or LDL level ≥ 2.6 mmol/L.
Exclusion criteria:
a. being pregnant or lactating;
b. having a known psychiatric/psychological disorder that could impair judgement and memory;
c. unable to read or understand English or Malay;
d. score ≥ 20 on the 9‐item Patient Health Questionnaire 9 (PHQ‐9).
Note: at baseline, the intervention and control group scores for the PHQ‐9 were, respectively, 4.3 (3.3) and 6.0 (4.8).
Stated purpose: to evaluate the effectiveness of a brief, value‐based emotion‐cognition‐focused educational program (VEMOFIT) in Malay adults with type 2 diabetes mellitus
Interventions Name: Value‐Based and Emotion‐Focused Educational Programme (VEMOFIT)
Title/name of PW and number: nurse‐coaches and doctors (number not specified)
1. Selection: not specified
2. Educational background: healthcare background (nurses and doctors)
3. Training: nurse‐coaches and doctors were trained to conduct both programmes at their own health clinics, supported by respective intervention materials and presentation slides.
4. Supervision: not specified
5. Incentives/remuneration: not specified
Prevention type: indicated prevention – intervention aimed at adults with type 2 diabetes mellitus presenting with distress but excluding those with a score on the Patient Health Questionnaire 9 (PHQ‐9) indicative of severe depression
Intervention details: the VEMOFIT consisted of four biweekly group sessions exploring personal values and providing diabetes education (session 1), a training on recognizing (session 2) and managing emotions (session 3) in the self and others, providing social support and setting short‐ and long‐term goals (session 4), and a booster session 3 months after the last session of the main intervention, reviewing the patient’s goals and rehearsing the content of the fourth session. Each participant was allowed to bring along one significant other as a co‐participant.
Control: active control – participants in the attention control program were offered three sessions over the same period to discuss emotional experiences, social support at home, and health clinic services regarding diabetes. They were not accompanied, and the sessions were not structured according to any module. The nurse‐coaches and doctors leading the attention control programme were trained in active listening.
Outcomes Participants’outcomes of interest for this review
  1. Depressive symptoms – PHQ‐9

  2. Distress/PTSD symptoms – DDS

  3. Quality of life – World Health Organization Quality‐of‐Life Scale (WHOQOL‐BREF)

  4. Psychological functioning and impairment – Summary of Diabetes Self‐Care Activities (SDSCA)


Carers’outcomes of interest for this review
Nil
Economic outcomes
Nil
Time points: baseline, post‐intervention (< 1 month, 1‐6 months, 7‐24 months)
Notes Source of funding: the trial is funded by the Malaysian MOHNIH Research Grant (MRG). This funding source had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data, or decision to submit results.
Notes on validation of instruments (screening and outcomes): the Malay versions of the DDS, PHQ‐9, and Summary of Diabetes Self‐Care Activities (SDSCA) were reported to be validated.
Additional information: none
Handling the data: not applicable
Prospective trial registration number: NCT02730078