The Mobile Insulin Titration Intervention (MITI) for Insulin Adjustment in an Urban, Low-Income Population: Randomized Controlled Trial.
Source: Levy, N., et al. 2015 - Pubmed ID: 26187303
Setting: USA, Hospital
Study design:
RCT
Follow up: 12 weeks
Patient group:
Sample size:
Total: 61 (41)
IG: 33 (27)
CG: 28 (14)
Inclusion criteria:
- Initiating insulin glargine or requiring the titration of an existing insulin glargine dose
- HbA1c ≥ 8%
Type of technology:
SMS
- Data transfer
- Messaging
Phone call
- Guidance
Intervention:
Intervention: Pt responds daily text messaging with their blood glucose value. Diabetes nurse monitor the values and call patient if values were alarming. Patients call nurse if needed. The nurse reviewed values once a week to adjust the insulin dose
Duration: 12 weeks
Add on: NA
Control group: Usual care
Clinical effect:
- Reaching optimal insulin glargine dose ↑
- HbA1c →
Patient safety: 5 cases of hypoglycemia 3 in IG and 2 in CG
Patient experiences/
Staff experiences:
Patient experiences:
- High (based on quotes)
Staff experiences:
- Text messages reply rate 84.3%
- Phone call reach rate 91%
- Review blood glucose 1 min.
- Titration review 7-11 min/pt
- Phone call (mean) 11.2 minutes
Investment:
Staff resources
- Developing message system
Running:
Staff resources
- Monitoring data
- Phone call patients
Organization: NA
Health care utilization:
- In person titration interaction ↓