Improving HbA(1c) with Glucose Self-Monitoring in Diabetic Patients with EpxDiabetes, a Phone Call and Text Message-Based Telemedicine Platform: A Randomized Controlled Trial
| Autor: | Robert Peters, Will Ross, Carlos Bernal-Mizrachi, Ran Xu, Kavon Javaherian, Maggie Xing |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Telemedicine
medicine.medical_specialty 020205 medical informatics Health Informatics 02 engineering and technology Text message law.invention Health Information Management Randomized controlled trial law Diabetes mellitus Intervention (counseling) 0202 electrical engineering electronic engineering information engineering medicine Humans Original Research Text Messaging business.industry General Medicine medicine.disease Digital health Adjunct Glucose Diabetes Mellitus Type 2 Physical therapy Self-monitoring business |
| Zdroj: | Telemed J E Health |
| Popis: | Background: We conducted a randomized controlled trial of EpxDiabetes, a novel digital health intervention as an adjunct therapy to reduce HbA(1c) and fasting blood glucose (FBG) among patients with type 2 diabetes mellitus (T2DM). In addition, we examined the effect of social determinants of health on our system. Methods: Sixty-five (n = 65) patients were randomized at a primary care clinic. Self-reported FBG data were collected by EpxDiabetes automated phone calls or text messages. Only intervention group responses were shared with providers, facilitating follow-up and bidirectional communication. ΔHbA(1c) and ΔFBG were analyzed after 6 months. Results: There was an absolute HbA(1c) reduction of 0.69% in the intervention group (95% confidence interval [CI], −1.41 to 0.02) and an absolute reduction of 0.03% in the control group (95% CI, −0.88 to 0.82). For those with baseline HbA(1c) >8%, HbA(1c) decreased significantly by 1.17% in the intervention group (95% CI, −1.90 to −0.44), and decreased by 0.02% in the control group (95% CI, −0.99 to 0.94). FBG decreased in the intervention group by 21.6 mg/dL (95% CI, −37.56 to −5.639), and increased 13.0 mg/dL in the control group (95% CI, −47.67 to 73.69). Engagement (proportion responding to ≥25% of texts or calls over 4 weeks) was 58% for the intervention group (95% CI, 0.373–0.627) and 48% for the control group (95% CI, 0.296–0.621). Smoking, number of comorbidities, and response rate were significant predictors of ΔHbA(1c). Conclusions: EpxDiabetes helps to reduce HbA(1c) in patients with uncontrolled T2DM and fosters patient–provider communication; it has definite merit as an adjunct therapy in diabetes management. Future work will focus on improving the acceptability of the system and implementation on a larger scale trial. |
| Databáze: | OpenAIRE |
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