Improvements in illness self-management and psychological distress associated with telemonitoring support for adults with diabetes.

Abstract:

OBJECTIVE:The objective of this observational open label trial was to characterize changes in diabetes self-management and psychological distress associated with a mobile health (mHealth) interactive voice response (IVR) self-management support program. METHODS:For 3-6 months, 301 patients with diabetes received weekly IVR calls assessing health status and self-care and providing tailored pre-recorded self-management support messages. Patients could participate together with an informal caregiver who received suggestions on self-management support, and patients' clinicians were notified automatically when patients reported significant problems. RESULTS:Patients completed 84% of weekly calls, providing 5682 patient-weeks of data. Thirty-nine percent participated with an informal caregiver. Outcome analyses adjusted for study design factors and sociodemographics indicated significant pre-post improvement in medication adherence, physical functioning, depressive symptoms, and diabetes-related distress (all p values <0.001). Analyses of self-management problems indicated that as the intervention proceeded, there were significant improvements in patients' IVR-reported frequency of weekly medication adherence, SMBG performance, checking feet, and frequency of abnormal self-monitored blood glucose readings (all p values <0.001). CONCLUSIONS:We conclude that the combined program of automated telemonitoring, clinician notification, and informal caregiver involvement was associated with consistent improvements in medication adherence, diabetes self-management behaviors, physical functioning, and psychological distress. A randomized controlled trial is needed to verify these encouraging findings.

journal_name

Prim Care Diabetes

journal_title

Primary care diabetes

authors

Aikens JE,Rosland AM,Piette JD

doi

10.1016/j.pcd.2014.06.003

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

127-34

issue

2

eissn

1751-9918

issn

1878-0210

pii

S1751-9918(14)00074-6

journal_volume

9

pub_type

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