Diabetes prevention through digital health: PRIME program based in Malaysian community pharmacies

Written by Ms Teoh Kah Woon, School of Pharmacy

Pre-diabetes Intervention, Management and Evaluation (PRIME) is a program that delivers prediabetes healthcare service and education through a mobile application. It educates patients with prediabetes on their condition and ways to prevent diabetes and empowers them to self-monitor and self-manage their condition.

Malaysia has the highest rate of obesity in South East Asia and recorded a high burden of type-2 diabetes mellitus (T2DM), where 1 in 5 are affected. Among the higher risk groups are those with lower income, especially the urban poor, due to poorer health literacy and behaviour in disease prevention. However, we have identified some disparities in prediabetes management in Malaysia. First of all, no introduction of service to manage this condition, although prediabetes is reversible. Currently, available services such as Diabetes Mellitus Therapy Adherence Clinic targets only the diabetic population. It is only available in appointed government healthcare facilities such as hospitals and public clinics (Klinik Kesihatan). Secondly, there is an underutilisation of community pharmacies to provide disease management services in Malaysia. Thirdly, digital health technology can improve patient adherence and facilitate real-time monitoring of vital biological measurements (i.e. via wearables, Bluetooth glucometer).

This research project will help detect individuals with prediabetes and engage them in a lifestyle program that emphasises diet and exercise changes. At the end of the study, we aim to help participants achieve a 5% weight loss and, if possible, lower blood glucose to normal levels. This program would potentially introduce a new disease management practice for prediabetes among community pharmacies or even other relevant healthcare services. In the long run, we hope to alleviate diabetes and obesity burden in Malaysia.

To our best knowledge, no development of mobile health application coupled with pharmacy service to deliver lifestyle interventions to people with prediabetes in Malaysia so far. Caring Pharmacy and Bionime (Malaysia) are collaborating with us for this project. Caring Pharmacy will deliver the program through its selected outlets. Meanwhile, participants will use the Bluetooth glucometer from Bionime for blood glucose self-monitoring. The project feasibility results will help both parties to improve their quality and variety of services since they have existing mobile health services. On top of that, Caring Pharmacy could also generate a more significant customer pool.

We aim to kickstart the pilot study in January 2022. In the future, we plan to include some potential features, such as introducing a reward system, gamification, and translating educational modules into the other local languages. The Monash Network for Equity through Digital Health (NEED) grant funds this project. The project will complete in December 2023.