Cluster-Randomized Trial of a Mobile Phone Personalized Behavioral Intervention for Blood Glucose Control
By Charlene C. Quinn, Michelle D Shardell, M. Terrin, Erik A. Barr, S. Ballew, Ann L. Gruber-Baldini. Diabetes Care, 2011
643 citations recorded by the source corpus.
OBJECTIVE To test whether adding mobile application coaching and patient/provider web portals to community primary care compared with standard diabetes management would reduce glycated hemoglobin levels in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS A cluster-randomized clinical trial, the Mobile Diabetes Intervention Study, randomly assigned 26 primary care practices to one of three stepped treatment groups or a control group (usual care). A total of 163 patients were enrolled and included in analysis. The primary outcome was change in glycated hemoglobin levels over a 1-year treatment period. Secondary outcomes were changes in patient-reported diabetes symptoms, diabetes distress, depression, and other clinical (blood pressure) and laboratory (lipid) values. Maximal treatment was a mobile- and web-based self-management patient coaching system and provider decision support. Patients received automated, real-time educational and behavioral messaging in response to individually analyzed blood glucose values, diabetes medications, and lifestyle behaviors communicated by mobile phone. Providers received quarterly reports summarizing patient’s glycemic control, diabetes medication management, lifestyle behaviors, and evidence-based treatment options. RESULTS The mean declines in glycated hemoglobin were 1.9% in the maximal treatment group and 0.7% in the usual care group, a difference of 1.2% (P = 0.001) over 12 months. Appreciable differences were not observed between groups for patient-reported diabetes distress, depression, diabetes symptoms, or blood pressure and lipid levels (all P > 0.05). CONCLUSIONS The combination of behavioral mobile coaching with blood glucose data, lifestyle behaviors, and patient self-management data individually analyzed and presented with evidence-based guidelines to providers substantially reduced glycated hemoglobin levels over 1 year.
Subfields: Endocrinology, Diabetes and Metabolism, General Health Professions
View Paper: https://www.semanticscholar.org/paper/b674c654fb1f54e3e54719914a5cdcf615bc58dd
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In Endocrinology, Diabetes and Metabolism
In General Health Professions
Citations in the corpus
- Impact of mHealth Chronic Disease Management on Treatment Adherence and Patient Outcomes: A Systematic Review (2015, neutral): “One study demonstrated the dual benefits of both better access to patient data and mobile coaching [65].”
- The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review (2013, positive): “Four trials of a diabetes care intervention, three involving text messages and the other involving video messages, reported statistically significant decreases in HBA1C, which were of borderline clinical significance [69–73].”
- The Effectiveness of Self-Management Mobile Phone and Tablet Apps in Long-term Condition Management: A Systematic Review (2016, background): “Only 1 study [23] specifically sought to explore whether sending clinicians’ data improved clinical outcomes.”
- Design of an mHealth App for the Self-management of Adolescent Type 1 Diabetes: A Pilot Study (2012, methodology): “9% drop in HbA1c in the intervention group using a mobile phone-based remote monitoring and coaching system [16].”
- Estimating Dynamic Treatment Regimes in Mobile Health Using V-learning (2016, methodology): “Although mobile technology has been successfully utilized in clinical areas such as diabetes (Quinn et al., 2011; Maahs et al., 2012), smoking cessation (Ali et al., 2012), and obesity (Bexelius et al., 2010), mHealth poses some unique challenges that preclude direct application of existing…”
- Behavioral Functionality of Mobile Apps in Health Interventions: A Systematic Review of the Literature (2015, methodology): “Of the four interventions related to diabetes, three reported a positive change in glycated hemoglobin: Kirwan et al [29] and Quinn et al [32] showed a significant decrease in HbA1c levels, while Wayne et al [39] showed a significant decrease only for those whose baseline HbA1c levels were above 7%.”