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

Study design:

RCT

Follow up: 12 ± 2 weeks

Patient group:

Sample size:

Total: 40 (35)

IG: 20 (19)

CG: 20 (16)

 

Inclusion criteria:

– Diabetes type 2

– HbA1c levels of 9-14%

Type of technology:

Home monitoring equipment

– Blood glucose

 

App

– Diabetes management program (on tablet)

– Secure messaging

– Shared screen control

– video and voice communication.

Intervention:

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/ Patient safety:

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/ Staff experiences:

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

Costs and organization:

Investment:

Home monitoring equipment

– 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

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Information

“↑”: Statistically significant increase

“↓”: Statistically significant decrease

“→”: Statistically insignificant (no difference)