Self-monitoring diabetes with multiple mobile health devices (original) (raw)
Related papers
2019
BACKGROUND Self-management is integral for control of type 2 diabetes mellitus (T2DM). Patient self-management is improved when they receive real-time information on their health status and behaviors and ongoing facilitation from health professionals. Yet, timely information for these behaviors is notably absent in the healthcare system. Providing real-time data could help improve patient understanding of the dynamics of their illness and assist clinicians in developing targeted approaches to improve health outcomes and in delivering personalized care when and where it is most needed. Mobile technologies (e.g., wearables, apps, connected scales) have the potential to make these patient-provider interactions a reality. To date, there are no studies on the application of these devices for real-time care and tracking data related to T2DM. What strategies might best help patients overcome self-management challenges using self-generated diabetes-related data? How might clinicians effecti...
Mobile health technology in the prevention and management of Type 2 diabetes
Indian Journal of Endocrinology and Metabolism, 2017
Review Article intRoDuCtion Globally, Type 2 diabetes mellitus (T2DM) prevalence has increased to about 415 million in 2015, [1] and it is estimated to rise to 642 million by 2040, equivalent to around one in ten adults. [2] According to the International Diabetes Federation, a person with diabetes spends only about 10 h with their physician in a whole year. [3] Although mobile health (mHealth) may not be a substitute for professional health care, it could play a supportive role in diabetes prevention and management by empowering individuals with information related to the primary, secondary, and tertiary prevention so that they might be able to make knowledgeable decisions about their lifestyle and behaviors. [3] Given that T2DM prevention and management is largely dependent on individual behaviors, extending support beyond the clinic may help in self-management. There have been many interventions looking at the effect of face-to-face interventions to support T2DM prevention and management such as the Da Qing study, [4] Finnish Diabetes Prevention study, [5] US Diabetes Prevention Program (DPP), [6] and Indian Diabetes Prevention Program. [7] A less study population are those made recently accessible through the numbers of mobile phone users having increased to over 3 billion (and rapidly rising). [8] Furthermore, mobile phones, which are now referred to as smartphones, bring wireless technology providing the capacity to provide instant access to information and aid in instant communication. [9] This sets the platform for health care to use this ubiquitous advantage in the prevention and management of chronic diseases. The aim of this narrative review is to present an overview of the mHealth technologies used for prevention and management of T2DM. We conducted a review of the literature using common online library databases including MEDLINE, PsycINFO, Embase, and many more. The databases were searched between Essential steps in diabetes prevention and management include translating research into the real world, improving access to health care, empowering the community, collaborative efforts involving physicians, diabetes educators, nurses, and public health scientists, and access to diabetes prevention and management efforts. Mobile phone technology has shown wide acceptance across various ages and socioeconomic groups and offers several opportunities in health care including self-management as well as prevention of Type 2 diabetes mellitus (T2DM). The future seems to lie in mobile health (mHealth) applications that can use embedded technology to showcase advanced uses of a smartphone to help with prevention and management of chronic disorders such as T2DM. This article presents a narrative review of the mHealth technologies used for the prevention and management of T2DM. Majority (48%) of the studies used short message service (SMS) technology as their intervention while some studies (29%) incorporated applications for medication reminders and insulin optimization for T2DM management. Few studies (23%) showed that, along with mHealth technology, health-care professionals' support resulted in added positive outcomes for the patients. This review highlights the fact that an mHealth intervention need not be restricted to SMS alone.
BMJ Open, 2019
IntroductionType 2 diabetes is common, affecting over 400 million people worldwide. Risk of serious complications can be reduced through use of effective treatments and active self-management. However, people are often concerned about starting new medicines and face difficulties in taking them regularly. Use of brief messages to provide education and support self-management, delivered through mobile phone-based text messages, can be an effective tool for some long-term conditions. We have developed messages aiming to support patients’ self-management of type 2 diabetes in the use of medications and other aspects of self-management, underpinned by theory and evidence. The aim of this trial is to determine the feasibility of a large-scale clinical trial to test the effectiveness and cost-effectiveness of the intervention, compared with usual care.Methods and analysisThe feasibility trial will be a multicentre individually randomised, controlled trial in primary care recruiting adults ...
PubMed, 2015
The mobile Digital Access to a Web-enhanced Network (mDAWN) program was implemented as an online, mobile self-management system to support patients with type-2 diabetes and their informal caregivers. Patients used wireless physiological sensors, received text messages, and had access to a secure web platform with health resources and semi-facilitated discussion forum. Outcomes were evaluated using (1) pre and post self-reported health behavior measures, (2) physiological outcomes, (3) program cost, and (4) in-depth participant interviews. The group had significantly decreased health distress, HbA1c levels, and systolic blood pressure. Participants largely saw the mDAWN as providing good value for the costs involved and found the program to be empowering in gaining control over their diabetes. mHealth programs have the potential to improve clinical outcomes through cost effective patient-led care for chronic illness. Further evaluation needs to examine integration of similar mHealth programs into the patient-physician relationship.
BMC Medical Informatics and Decision Making, 2016
Background: Management of diabetes through improved glycemic control and risk factor modification can help prevent long-term complications. Much diabetes management is self-management, in which healthcare providers play a supporting role. Well-designed e-Health solutions targeting behavior change can improve a range of measures, including glycemic control, perceived health, and a reduction in hospitalizations. Methods: The primary objective of this study is to evaluate if a mobile application designed to improve self-management among patients with type 2 diabetes (T2DM) improves glycemic control compared to usual care. The secondary objectives are to determine the effects on patient experience and health system costs; evaluate how and why the intervention worked as observed; and gain insight into considerations for system-wide scale-up. This pragmatic, randomized, wait-list-control trial will recruit adult participants from three Diabetes Education Programs in Ontario, Canada. The primary outcome is glycemic control (measured by HbA1c). Secondary outcomes include patient-reported outcomes and patient-reported experience measures, health system utilization, and intervention usability. The primary outcome will be analyzed using an ANCOVA, with continuous secondary outcomes analyzed using Poisson regression. Direct observations will be conducted of the implementation and application-specific training sessions provided to each site. Semi-structured interviews will be conducted with participants, healthcare providers, organizational leaders, and system stakeholders as part of the embedded process evaluation. Thematic analysis will be applied to the qualitative data in order to describe the relationships between (a) key contextual factors, (b) the mechanisms by which they effect the implementation of the intervention, and (c) the impact on the outcomes of the intervention, according to the principles of Realist Evaluation. Discussion: The use of mobile health and virtual tools is on the rise in health care, but the evidence of their effectiveness is mixed and their evaluation is often lacking key contextual data. Results from this study will provide much needed information about the clinical and cost-effectiveness of a mobile application to improve diabetes self-management. The process evaluation will provide valuable insight into the contextual factors that influence the application effectiveness, which will inform the potential for adoption and scale.
JMIR research protocols, 2018
Nonadherence to self-care is common among patients with type 2 diabetes (T2D) and often leads to severe complications. Moreover, patients with T2D who have low socioeconomic status and are racial/ethnic minorities disproportionately experience barriers to adherence and poor outcomes. Basic phone technology (text messages and phone calls) provides a practical medium for delivering content to address patients' barriers to adherence; however, trials are needed to explore long-term and sustainable effects of mobile phone interventions among diverse patients. The aim of this study is to evaluate the effects of mobile phone-based diabetes support interventions on self-care and hemoglobin A (HbA) among adults with T2D using a 3-arm, 15-month randomized controlled trial with a Type 1 hybrid effectiveness-implementation approach. The intervention arms are (1) Rapid Encouragement/Education And Communications for Health (REACH) and (2) REACH + Family-focused Add-on for Motivating Self-care...
Frontiers in Public Health, 2022
Introduction: Type 2 diabetes mellitus (T2DM) poses huge burden and cost on the healthcare system. Mobile health (mHealth) interventions that incorporate wearables may be able to improve diabetes self-management. The aim of this randomized controlled trial (RCT) is to investigate the clinical and cost-effectiveness of personalized educational and behavioral interventions delivered through an EMPOWER mobile application (app) among patients with T2DM. Methods: This is a parallel two-arm randomized controlled trial (RCT). Patients with T2DM recruited from primary care will be randomly allocated in a 1:1 ratio to either intervention or control group. The intervention group will receive personalized educational and behavioral interventions through the EMPOWER app in addition to their usual clinical care. The control group will receive the usual clinical care for their T2DM but will not have access to the EMPOWER app. Our primary outcome is patient activation score at 12 months. Secondary outcomes will include HbA1c, physical activity level and diet throughout 12 months; quality of life (QoL), medication adherence, direct healthcare cost and indirect healthcare cost at 6 and 12 months. Discussion: This RCT will provide valuable insights into the effectiveness and implementation of personalized educational and behavioral interventions delivered through mobile application in T2DM management. Findings from this study Kwan et al. Diabetes and Smartphone App can help to achieve sustainable and cost-effective behavioral change in patients with T2DM, and this can be potentially scaled to other chronic diseases such as hypertension and dyslipidemia.
Long-term engagement with a mobile self-management system for people with type 2 diabetes
JMIR mHealth and uHealth, 2013
In a growing number of intervention studies, mobile phones are used to support self-management of people with Type 2 diabetes mellitus (T2DM). However, it is difficult to establish knowledge about factors associated with intervention effects, due to considerable differences in research designs and outcome measures as well as a lack of detailed information about participants' engagement with the intervention tool. To contribute toward accumulating knowledge about factors associated with usage and usability of a mobile self-management application over time through a thorough analysis of multiple types of investigation on each participant's engagement. The Few Touch application is a mobile-phone-based self-management tool for patients with T2DM. Twelve patients with T2DM who have been actively involved in the system design used the Few Touch application in a real-life setting from September 2008 until October 2009. During this period, questionnaires and semistructured interview...
Novel Health Mobile Technology as an Emerging Strategy in Diabetes Management
Advances in mobile phone technology and its applications coupled with equally robust growth of telecommunication technology can serve to give patients a better access to the healthcare. More and more healthcare providers and patients started using these applications. Mobile applications are useful in handling various aspects of healthcare namely, health promotion and disease prevention, diagnosis, treatment, monitoring and supporting health services. Clinical studies evaluating mobile applications often come up with mixed results. In this chapter, application of mobile health technology or mHealth in diabetes management is presented as a case study. We have reviewed 25 articles from pubmed database that fulfilled our selection criteria which included original clinical studies that evaluated mobile health technology in the management of diabetes mellitus. Most studies (88%) reported positive outcomes after use of the mobile health applications in various aspects of diabetes treatment such as disease management, behavioural monitoring and patient education. Educational SMS were effective but inferior to Smartphone Apps or teleconsultations. User-friendliness of the systems influenced patient compliance and outcomes. Smartphone/web applications offer significant benefits for patient care, education and behavioural modifications. As providing continuous patient support would require adequate infrastructure and personnel, cost effectiveness of such interventions need to be studied.