Medication Optimization Among People With Type 2 Diabetes Participating in a Continuous Glucose Monitoring-Driven Virtual Care Program: Prospective Study.

Autor: Majithia AR; Department of Medicine, University of California San Diego School of Medicine, La Jolla, CA, United States.; Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, CA, United States., Erani DM; Onduo Professionals PC, Newton, MA, United States., Kusiak CM; Verily Life Sciences, South San Francisco, CA, United States., Layne JE; Onduo LLC, Newton, MA, United States., Lee AA; Verily Life Sciences, South San Francisco, CA, United States., Colangelo FR; Allegheny Health Network, Monroeville, PA, United States., Romanelli RJ; Sutter Health, Palo Alto, CA, United States., Robertson S; Verily Life Sciences, South San Francisco, CA, United States., Brown SM; Onduo LLC, Newton, MA, United States., Dixon RF; Onduo LLC, Newton, MA, United States., Zisser H; Verily Life Sciences, South San Francisco, CA, United States.
Jazyk: angličtina
Zdroj: JMIR formative research [JMIR Form Res] 2022 Apr 05; Vol. 6 (4), pp. e31629. Date of Electronic Publication: 2022 Apr 05.
DOI: 10.2196/31629
Abstrakt: Background: The Onduo virtual care program for people with type 2 diabetes (T2D) includes a mobile app, remote lifestyle coaching, connected devices, and telemedicine consultations with endocrinologists for medication management and prescription of real-time continuous glucose monitoring (RT-CGM) devices. In a previously described 4-month prospective study of this program, adults with T2D and baseline glycated hemoglobin (HbA 1c ) ≥8.0% to ≤12.0% experienced a mean HbA 1c decrease of 1.6% with no significant increase in hypoglycemia.
Objective: The objective of this analysis was to evaluate medication optimization and management in the 4-month prospective T2D study.
Methods: Study participants received at least 1 telemedicine consultation with an Onduo endocrinologist for diabetes medication management and used RT-CGM intermittently to guide therapy and dosing. Medication changes were analyzed.
Results: Of 55 participants, 48 (87%) had a medication change consisting of a dose change, addition, or discontinuation. Of these, 15 (31%) participants had a net increase in number of diabetes medication classes from baseline. Mean time to first medication change for these participants was 36 days. The percentage of participants taking a glucagon-like peptide-1 receptor agonist increased from 25% (12/48) to 56% (n=27), while the percentages of participants taking a sulfonylurea or dipeptidyl peptidase 4 inhibitor decreased from 56% (n=27) to 33% (n=16) and 17% (n=8) to 6% (n=3), respectively. Prescriptions of other antidiabetic medication classes including insulin did not change significantly.
Conclusions: The Onduo virtual care program can play an important role in providing timely access to guideline-based diabetes management medications and technologies for people with T2D.
Trial Registration: ClinicalTrials.gov NCT03865381; https://clinicaltrials.gov/ct2/show/NCT03865381.
(©Amit R Majithia, David M Erani, Coco M Kusiak, Jennifer E Layne, Amy Armento Lee, Francis R Colangelo, Robert J Romanelli, Scott Robertson, Shayla M Brown, Ronald F Dixon, Howard Zisser. Originally published in JMIR Formative Research (https://formative.jmir.org), 05.04.2022.)
Databáze: MEDLINE
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