BOSTON – A mobile health diabetes self-management system improves diabetes knowledge, reminds users to take medications and attend appointments, and helps with health-related goal setting, according to findings in patients who used the system for at least 6 months.
The system – Care4life – is a mobile text, e-mail, app, and web-based system developed by digital health provider Voxiva in collaboration with the American Diabetes Association. It provides individualized education and reminders and can log and track blood glucose, weight, exercise, and blood pressure. Summary reports of progress in meeting treatment goals can be generated and shared with providers who can then help patients in their treatment and self-management decision making.
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Of the 10,740 patients who enrolled in the Care4Life system through the ADA’s Living With Type 2 Diabetes Website between July 2013 and December 2014 and who used the system for at least 180 days, 97.7% were still receiving educational content after 6 months. Nearly 76% received that content via e-mail, and 68% received it by text message instead of, or in addition to, e-mail, Dr. Joshua L. Cohen reported at the annual scientific sessions of the American Diabetes Association.
About a quarter of the participants had used the system to set a weight loss goal, and 22% used it to set an exercise goal. About 10% used it for medication reminders, and 31% entered at least one health-related report (such as blood glucose measures, weight, blood pressure, medication compliance, or exercise activity.) About 80% of those who set a weight loss or exercise goal submitted at least one report.
About 10% entered one or more blood glucose reports, and of those, 68% entered a report during the first 30 days of system use, a third did so during days 90-120, and 22% did so at 180 or more days after enrollment.
Of 3,263 participants who completed a survey after 180 days of using the Care4Life system, 89% said the system improved their knowledge of diabetes, and 69% said the system helped them remember to take medications and attend appointments, said Dr. Cohen, professor of medicine at George Washington University, Washington, D.C., as well as director of both the diabetes and thyroid centers there.
Further, 82% of respondents reported that the system helped them set health goals, and about 96% said they would recommend the system to other patients with diabetes, he noted.
“Our patients need to make frequent decisions and choices in their personal management of diabetes. As physicians and health educators, one of our major tasks is to provide support to our patients in their own decision making,” Dr. Cohen said.
Although several randomized controlled trials have evaluated mobile health applications and systems and demonstrated benefit, most have been small studies.
The current study included a much larger patient population and further demonstrated the value of this type of technology, he said, noting that the areas of greatest interest were weight management and exercise.
Of note, although a considerable number of patients were still reporting blood glucose levels after 180 days (and the average levels declined over time), only 1% of participants requested reminders regarding blood pressure.
“The latter I find particularly interesting since, as we are all aware, hypertension is indeed a significant contributor to the morbidity and mortality associated with diabetes, and yet – at least in this patient group – the message may not be getting through about the significance of hypertension,” he said.
Dr. Cohen is on speakers panels for AstraZeneca and Pfizer, and he disclosed that one of his study coauthors has a financial interest in Voxiva.