Sunday, October 30, 2011

mPhones Helping Diabetics

In a study supported by AHRQ, researchers affiliated with the University of Washington and a local HMO enables patients to wirelessly upload blood-glucose values through mobile phones, communicate through email with a care manager, and access their shared medical record from a system at home. Participants were trained to access the system through a smart phone, personal computer, and through the web.

After interviews with eight patients to discuss their experience, several themes emerged. The researchers concluded that connecting with nurse practitioners was valuable, some individuals are very receptive to using web-based and mobile communication services to help manage their diabetes, uploading data from wireless glucose meters was easy, but using the technology could sometimes be frustrating to self-managing diabetes.

The University of Maryland’s School of Medicine reports in a study published in ‘Diabetes Care” that an interactive computer software program appears to be effective in helping patients’ mange their Type 2 diabetes using their mobile phones.

The study one of the first to scientifically examine mobile health technology found that a key measure of blood sugar control was lowered by an average of 1.9 percent over a period of one year in patients using the mobile health software. The findings support further exploring mobile health approaches to use to manage many chronic conditions including diabetes.

The study enrolled 163 patients with the help of 39 primary care doctors in Baltimore County, Baltimore City, Montgomery County, and Anne Arundel County in Maryland. Patients were divided into four groups based on the research assignment of their physician. Three patient groups received mobile phones loaded with diabetes management software and the fourth group served as a control group. All patients in the study received a free blood glucose meter and testing supplies.

The software examined provided real-time feedback, displayed medication regimens, and served as a “virtual coach”. The system analyzed blood sugar levels and other patient information, sent computer-generated logbooks, and suggested treatment plans to the patients’ primary care doctor.

A clinical trial listed on sponsored by the University of Southern California is looking at using text-messaging based mHealth with emergency department diabetic patients. The trial referred to as “TExT-MED”, uses unidirectional daily text messages consisting of educational materials, trivia questions, and challenges to promote healthy lifestyle choices, along with reminders to check blood sugar and take medications.

The trial is currently recruiting up to 200 participants ages 18 to 80 that have Type 2 diabetes, have a text message capable mobile phone, and speak and read English or Spanish. The study is expected to be completed July 2012.

The principal contact is Sanjay Arora, MD at (323) 226-6667. The identifier is (NCT01403831).

In another program sponsored by the McKesson Foundation $1.4 million in research funding was awarded to the second generation of “Mobilizing for Health” grant recipients. The funding will help researchers from six institutions investigate how mobile phones can be used to improve the lives of underserved populations suffering from chronic diseases but the program is especially geared to helping diabetics.

The 2012 grants recipients include:

• Baystate Medical Center is going to field test an integrated mHealth solution to improve daily adherence to medications and blood glucose and blood pressure monitoring among older Type 2 diabetes patients

• Albert Einstein Medical Center will examine how doctors and nurses with regular feedback from their diabetic patients use integrated mobile phone technology to improve blood sugar control

• Center for Connected Health, Partners HealthCare in Boston will integrate a text-messaging program with the existing DSME program at 3 MGH community health centers representing medically underserved and low income populations. The goal is to assess the effect of personalized text messages on clinical outcomes and physical activity in patients with Type2 diabetes. Personalized text messages will include coaching to improve activity levels and reminders and will be offered in English and Spanish

• Medic Mobile will develop and pilot an SMS-based appointment validation tool to automate the process of confirming and rescheduling appointments for low-income diabetic patients

• Scripps Whittier Diabetes Institute will test the effectiveness of using a mobile health application to improve the management of diabetes in a recently diagnosed diabetic Latino population

• Vanderbilt University Medical Center will design and test a mobile assessment and intervention system for low-income adults with Type 2 diabetes

Letters of Intent for the next “Mobilizing for Health” grant cycle will be accepted beginning in January 2012. For further information, go to