# Implementation of Digital Device–Assisted and Nurse-Led Case Management to Promote Self-Management in Adults With Noncommunicable Diseases: Protocol for a Single-Arm Intervention Study

## TL;DR

This study tests a digital and nurse-led approach to help adults with noncommunicable diseases better manage their health and reduce cardiovascular risks.

## Contribution

The study introduces a combined digital and nurse-led self-management intervention in a real-world community setting for noncommunicable disease prevention.

## Key findings

- The intervention includes digital tools like smartwatches and a salt meter alongside nurse-led case management.
- The study will assess the impact of the intervention on self-management behaviors and clinical outcomes over 24 weeks.
- Results may inform future large-scale trials and improvements in noncommunicable disease care systems.

## Abstract

Self-management plays a vital role in noncommunicable disease prevention and control. However, it has been challenging for patients and their caregivers to identify how much their lifestyle affects their health and what level of effort they should make to reduce cardiovascular disease (CVD) risks in everyday life. Therefore, knowing their own CVD risk and daily health-related situations will provide relevant information for self-management by those at risk. The need to help individuals understand their relevant information creates an opportunity to investigate whether and how to implement a combined digital and nurse-led self-management intervention in a real-world community setting.

This study aims to evaluate the effectiveness of a combined approach combining digital device support, including a smartwatch, a mobile app, and a salt meter, with nurse-led case management, on self-management behaviors and clinical outcomes.

This study uses a combination of a nurse-led self-management with a digital and mobile health innovative approach, including tailored small group face-to-face education sessions, a smartwatch, a smartphone health app, and a salt meter, to increase the self-management behaviors to reduce vascular risk through designing and testing an integrated community-based strategy targeted at adults and older adults at risk of CVD in Thailand. The study uses a single-arm pretest-posttest design to assess the intervention’s effects. The intervention will consist of the following components: (1) an interactive face-to-face education session; (2) a real-time knowing your numbers strategy using a smartwatch, a smartphone health app, and a salt meter; (3) a mindfulness-based stress management strategy using Somporn Kantaradusdi-Triamchaisri technique meditation healing exercise; and (4) a self-management diary. Quantitative data will be collected using a smartwatch, a salt meter, a food diary, and questionnaires at baseline and at the end of week 6. Clinical outcomes will be assessed at baseline, primary end point (wk 12), and secondary end point (wk 24).

This study, funded in January 2025, will involve 45 patients. We received ethical approval on May 31, 2024, and began recruitment for participation in May 2025. Researchers will collect, analyze, and synthesize to evaluate the study procedure. We expect to complete data collection by December 2025, with the first results submitted for publication in March 2026.

The implementation of a combined digital device and nurse-led case management may identify the use of digital health to support self-management and improve vascular health. The findings of this study will provide insights for a large-scale randomized controlled trial and for ongoing improvements in the noncommunicable disease care system.