Mobile phone-based video messages for diabetes self-care support

Amanda M Bell, Stephanie J Fonda, M Susan Walker, Virginia Schmidt, Robert A Vigersky, Amanda M Bell, Stephanie J Fonda, M Susan Walker, Virginia Schmidt, Robert A Vigersky

Abstract

Background: This study examined whether mobile phone-based, one-way video messages about diabetes self-care improve hemoglobin A1c (A1C) and self-monitoring of blood glucose (SMBG).

Methods: This was a 1-year prospective randomized trial with two groups. The active intervention lasted 6 months. The study enrolled 65 people with A1C >8.0% who were established (>6 months) patients in the endocrinology clinics of the Walter Reed Health Care System. Participants were randomized to receive "usual care" or self-care video messages from their diabetes nurse practitioner. Video messages were sent daily to cell phones of study participants. Hemoglobin A1c and SMBG data were collected at 0, 3, 6, 9, and 12 months.

Results: Participants who received the messages had a larger rate of decline in A1C than people who received usual care (0.2% difference over 12 months, adjusting for covariates; p = .002 and p = .004 for the interaction between time and group and for the quadratic effect of time by group, respectively). Hemoglobin A1c decline was greatest among participants who received video messages and viewed >10 a month (0.6% difference over 12 months, adjusting for covariates; p < .001 for the interaction between time and group and the quadratic effect). Self-monitoring of blood glucose metrics were not related to the intervention.

Conclusions: A one-way intervention using mobile phone-based video messages about diabetes self-care can improve A1C. Engagement with the technology is an important predictor of its success. This intervention is simple to implement and sustain.

© 2012 Diabetes Technology Society.

Figures

Figure 1
Figure 1
CONSORT diagram.
Figure 2
Figure 2
Mean change in A1C from baseline, by treatment group and over time. Change = later A1C – baseline A1C. (A) Two main treatment groups, video messages vs usual care. (B) Viewership groups within the video messages group, with the usual care group indicated as reference [note that this line is identical to the line in (A)]. The intervention ended at 6 months.

References

    1. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993;329(14):977–986.
    1. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998;352(9131):837–853.
    1. Hoerger TJ, Segel JE, Gregg EW, Saaddine JB. Is glycemic control improving in U.S. adults? Diabetes Care. 2008;31(1):81–86. Epub 2007 Oct 12.
    1. Wagner J, Malchoff C, Abbott G. Invasiveness as a barrier to self-monitoring of blood glucose in diabetes. Diabetes Technol Ther. 2005;7(4):612–619.
    1. Vincze G, Barner JC, Lopez D. Factors associated with adherence to self-monitoring of blood glucose among persons with diabetes. Diabetes Educ. 2004;30(1):112–125.
    1. Karter AJ, Ferrara A, Darbinian JA, Ackerson LM, Selby JV. Self-monitoring of blood glucose: language and financial barriers in a managed care population with diabetes. Diabetes Care. 2000;23(4):477–483.
    1. Nichol MB, Knight TK, Priest JL, Wu J, Cantrell CR. Nonadherence to clinical practice guidelines and medications for multiple chronic conditions in a California Medicaid population. J Am Pharm Assoc (2003) 2010;50(4):496–507.
    1. Kramer H, Cao G, Dugas L, Luke A, Cooper R, Durazo-Arvizu R. Increasing BMI and waist circumference and prevalence of obesity among adults with Type 2 diabetes: the National Health and Nutrition Examination Surveys. J Diabetes Complications. 2010;24(6):368–374. Epub 2009 Nov 14.
    1. Krishna S, Boren SA, Balas EA. Healthcare via cell phones: a systematic review. Telemed J E Health. 2009;15(3):231–240.
    1. Istepanian RS, Zitouni K, Harry D, Moutosammy N, Sungoor A, Tang B, Earle KA. Evaluation of a mobile phone telemonitoring system for glycaemic control in patients with diabetes. J Telemed Telecare. 2009;15(3):125–128.
    1. Krishna S, Boren SA. Diabetes self-management care via cell phone: a systematic review. J Diabetes Sci Technol. 2008;2(3):509–517.
    1. Kim HS, Jeong HS. A nurse short message service by cellular phone in type-2 diabetic patients for six months. J Clin Nurs. 2007;16(6):1082–1087.
    1. Kim HS, Kim NC, Ahn SH. Impact of a nurse short message service intervention for patients with diabetes. J Nurs Care Qual. 2006;21(3):266–271.
    1. Quinn CC, Clough SS, Minor JM, Lender D, Okafor MC, Gruber-Baldini A. WellDoc mobile diabetes management randomized controlled trial: change in clinical and behavioral outcomes and patient and physician satisfaction. Diabetes Technol Ther. 2008;10(3):160–168.
    1. Agarwal S, Lau CT. Remote health monitoring using mobile phones and Web services. Telemed J E Health. 2010;16(5):603–607.
    1. Mensing C. Chicago, IL: American Association of Diabetes Educators; 2006. The Art and Science of Diabetes Self-Management Education: A Desk Reference for Healthcare Professionals.
    1. Cho JH, Lee HC, Lim DJ, Kwon HS, Yoon KH. Mobile communication using a mobile phone with a glucometer for glucose control in Type 2 patients with diabetes: as effective as an Internet-based glucose monitoring system. J Telemed Telecare. 2009;15(2):77–82.
    1. Hanauer DA, Wentzell K, Laffel N, Laffel LM. Computerized Automated Reminder Diabetes System (CARDS): e-mail and SMS cell phone text messaging reminders to support diabetes management. Diabetes Technol Ther. 2009;11(2):99–106.
    1. Arsand E, Tatara N, Østengen G, Hartvigsen G. Mobile phone-based self-management tools for type 2 diabetes: the few touch application. J Diabetes Sci Technol. 2010;4(2):328–336.
    1. Fjeldsoe BS, Marshall AL, Miller YD. Behavior change interventions delivered by mobile telephone short-message service. Am J Prev Med. 2009;36(2):165–173.
    1. Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldini AL. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011;34(9):1934–1942. Epub 2011 Jul 25.

Source: PubMed

3
Prenumerera