Type II Diabetes Mellitus Clinical Trial
Official title:
Use of Mobile Health Technology as an Intervention for Type II Diabetes Self-Management
This purpose of this is study is to evaluate the effectiveness of an interactive mobile health information service, Care4Life, in supporting patient self-management of Type II Diabetes Mellitus.
This study evaluates the effectiveness of an interactive mobile health information service,
Care4Life, in supporting patient self-management through its ability to facilitate patient
education, behavior change, and improved adherence with standard care practices. The study
population comprises adults who have been diagnosed with Type 2 diabetes mellitus (DM) and a
hemoglobin A1c (HbA1c) test above 8% in the past year. All members of the study population
are treated at primary care clinics under the auspices of the Utah Beacon Community Program,
which aims to improve health through use of health information technology. We will compare
outcomes in two groups within this population: patients with DM who enroll in Care4Life (in
addition to receiving standard care) to patients with DM who receive standard care from
their physician. We will compare these groups both within the clinic and at an aggregated,
overall level.
This study relies on the use of information and communications technology (ICT) in
supporting patient-empowerment strategies. Features of successful diabetes care programs for
improving adherence to standards of care, such as the use of diabetes self-management
education, checklists that mirror guidelines, and automated reminders are well suited to
delivery using an interactive mobile health platform.
Research Questions
This study will evaluate the efficacy of the Care4Life mHealth program by:
1. Evaluating if a short message service via cell phone texting (SMS) protocol will lead
to improvements in clinical, utilization and satisfaction outcomes for patients with DM
compared to patient who receive standard care.
2. Evaluating if an SMS protocol can be readily adopted by an adult population in both
urban and rural areas with a time-consuming chronic illness.
Targeted outcomes include:
1. Improved measures of diabetes control, demonstrated as HbA1c percentage levels ≤ 8%;
improved blood pressure (BP) control, demonstrated as BP ≤ 140/90 millimeters mercury
(mm Hg); and lower body mass index (BMI) among users of the SMS-based tool.
2. Improved knowledge of self-care and disease management practices among adult patients
with diabetes treated in Beacon clinics in the Salt Lake Metropolitan Statistical Area
(Salt Lake, Tooele, and Summit counties).
3. Dissemination of results and proof of concept with the broader healthcare community in
Utah.
The mobile centric diabetes support service at the center of our study is Voxiva's Care4Life
platform, which is an interactive mobile application designed to educate participants,
encourage behavior change and promote adherence to their prescribed DM treatment protocol.
It includes a series of SMS-based tools that have been developed in collaboration with the
Instituto Carso de la Salud, located in Mexico. The service sends content relevant to the
target participants and their standard treatment protocol. Care4Life delivers an
individually tailored diabetes education and management plan based on data that are
collected from patients at enrollment and added to the participant's personal health
profile.
The SMS protocol draws on the experience of a number of interventions that have been
independently studied and shown to improve health outcomes. Care4Life functionality consists
of the following components: (1) a diabetes diary that can be used to develop a history of
glucose levels and trigger alerts and feedback based on the participant's results; (2)
health education with content tailored to the participant's health profile; (3) medication
adherence reminders and monitoring; (4) medical appointment reminders; (5) a database that
allows a participant to record and monitor her/his weight, BMI, blood pressure and
laboratory results; and (6) a health portal that allows a participant to review his/her
data, obtain advice and guidance based on the information entered, and manage his/her
preferences.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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