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/ Patient safety:

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%

-Telephone call reach rate 91%

-Review blood glucose 1 min.

-Titration review 7-11 min/pt

– Telephone call

(mean) 11.2 minutes.

Costs and organization:

Investment:

Staff resources

– developing message system

Running:

Staff resources

– Monitoring data

– Phone call patients

Organization:

NA

Health care utilization:

In person titration interaction ↓

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Information

“↑”: Statistically significant increase

“↓”: Statistically significant decrease

“→”: Statistically insignificant (no difference)