Utilization of a Cloud-Based Diabetes Management Program for Insulin Initiation and Titration Enables Collaborative Decision Making Between Healthcare Providers and Patients.
Source: Hsu, W. C., et al. 2016 - Pubmed ID: 26645932
Setting: USA, Diabetes center
RCT
Follow up: 12 ± 2 weeks
Sample size:
Total: 40 (35)
IG: 20 (19)
CG: 20 (16)
Inclusion criteria:
- Diabetes type 2
- HbA1c levels of 9-14%
Home monitoring
- Blood glucose
App
- Diabetes management program (on tablet)
- Secure messaging
- Shared screen control
- Video and voice communication.
Intervention: Patient instructed in mobile technology and the individual plan on initial visit with Health care provider. Virtual interactions (messaging and video/voice communication on regular basis as needed. In the beginning the HCPs monitored the glucose values remotely on a daily basis and modeled expert decision making through the communication features on the tablet but gradually intervened less frequently throughout the course of the study to encourage patient self-management.
Duration: 3 months
Add on: NA
Control group: Standard care at clinic
Clinical effect:
- Mean HbA1c ↓
- Reaching HbA1c target (≤7%) →
- Weight →
- Satisfaction (DTSQ) ↑ (improved)
Patient safety: Four subjects in the intervention group and two in the control group reported hypoglycemia during the study.
Patient experiences: High patient satisfaction (based on exit citation from interview)
Staff experiences:
- IG: Mean visit time: 22.5 min per subject
- CG: Mean visit time: 68.8 min per subject
Investment:
Equipment/Materials
- Tablet
- Glucometer
Running:
Staff resources
- Patient training in mobile tech (approx. 40 min)
- Monitoring of clinical data
- Communication with patients
Organization: NA
Health care utilization: NA