Effects of mobile health interventions on improving glycemic stability and quality of life in patients with type 1 diabetes: A meta‐analysis

Liu, Chin-Jung; Chiu, Hsiao‐Yean; Chuang, Yeu-Hui; Lin, Kun; Huang, Hui-Chuan

doi:10.1002/nur.22094

Cited by 8 publications

(2 citation statements)

References 74 publications

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“…mHealth technology has been proven to enhance the management of patients with chronic diseases [ 43 ] and is associated with a reduction in BP and better medication adherence for people with hypertension [ 44 ]. Also, mHealth‐based interventions for patients with type 1 DM significantly decreased HbA 1c , improved life satisfaction, and improved mental health [ 45 ]…”

Section: Discussionmentioning

confidence: 99%

Pandemic-Related Impairment in the Monitoring of Patients With Hypertension and Diabetes and the Development of a Digital Solution for the Community Health Worker: Quasiexperimental and Implementation Study

Cimini¹,

Maia²,

Pires³

et al. 2022

JMIR Med Inform

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Background The restrictions imposed by the COVID-19 pandemic reduced health service access by patients with chronic diseases. The discontinuity of care is a cause of great concern, mainly in vulnerable regions. Objective This study aimed to assess the impact of the COVID-19 pandemic on people with hypertension and diabetes mellitus (DM) regarding the frequency of consultations and whether their disease was kept under control. The study also aimed to develop and implement a digital solution to improve monitoring at home. Methods This is a multimethodological study. A quasiexperimental evaluation assessed the impact of the pandemic on the frequency of consultations and control of patients with hypertension and DM in 34 primary health care centers in 10 municipalities. Then, an implementation study developed an app with a decision support system (DSS) for community health workers (CHWs) to identify and address at-risk patients with uncontrolled hypertension or DM. An expert panel assessment evaluated feasibility, usability, and utility of the software. Results Of 5070 patients, 4810 (94.87%) had hypertension, 1371 (27.04%) had DM, and 1111 (21.91%) had both diseases. There was a significant reduction in the weekly number of consultations (107, IQR 60.0-153.0 before vs 20.0, IQR 7.0-29.0 after social restriction; P<.001). Only 15.23% (772/5070) of all patients returned for a consultation during the pandemic. Individuals with hypertension had lower systolic (120.0, IQR 120.0-140.0 mm Hg) and diastolic (80.0, IQR 80.0-80.0 mm Hg) blood pressure than those who did not return (130.0, IQR 120.0-140.0 mm Hg and 80.0, IQR 80.0-90.0 mm Hg, respectively; P<.001). Also, those who returned had a higher proportion of controlled hypertension (64.3% vs 52.8%). For DM, there were no differences in glycohemoglobin levels. Concerning the DSS, the experts agreed that the CHWs can easily incorporate it into their routines and the app can identify patients at risk and improve treatment. Conclusions The COVID-19 pandemic caused a significant drop in the number of consultations for patients with hypertension and DM in primary care. A DSS for CHW has proved to be feasible, useful, and easily incorporated into their routines.

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Section: Discussionmentioning

confidence: 99%

Pandemic-Related Impairment in the Monitoring of Patients With Hypertension and Diabetes and the Development of a Digital Solution for the Community Health Worker: Quasiexperimental and Implementation Study

Cimini¹,

Maia²,

Pires³

et al. 2022

JMIR Med Inform

View full text Add to dashboard Cite

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“…A recent systematic review conducted among Saudi patients who use mHealth applications showed a positive effect on their health-related behaviors and outcomes, with a higher rate of satisfaction in comparison to traditional care [ 14 ]. A meta-analysis attributed those results to self-management skills such as symptom awareness, monitoring, and management, which were all facilitated by mHealth applications [ 20 ]. Regarding FGM, Al Hayek's study [ 21 ], carried out in Saudi Arabia for patients with type 1 diabetes, found that the use of FGM increases the frequency of self-testing, thus helping to reduce the frequency of hypoglycemia and HbA1c level and to improve the quality of life compared to traditional testing methods.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Patients' Perspective About New Technologies Used in Managing Diabetes Mellitus in Saudi Arabia: A Cross-Sectional Study

Al-Nozha¹,

Alshareef²,

Aljawi³

et al. 2022

Cureus

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Background: Diabetes technologies are hardware, devices, and software that are used by people with diabetes to manage their condition, from lifestyle interventions to the monitoring of blood glucose levels. The development of these technologies is advancing, but their use in Saudi Arabia is under-researched. Objectives: To appraise the awareness of using new technological options in managing patients with diabetes and to assess the patients' satisfaction while using them. Method: This was an e-questionnaire-based cross-sectional study. The targeted population of the study was patients with diabetes in Saudi Arabia. A total of 452 respondents participated in a survey in the period between 2020 and 2021. The collected data were analyzed using descriptive statistical methods and Chi-squared tests. Results: Some 69% of participants were aware of the new technologies used in managing diabetes. There were discrepancies between the awareness and the use of new technologies. Several causes of non-use were identified; the main cause was high cost, as reported by more than half of non-users (53.2%). Other causes included non-availability and difficulty of use. Mobile health applications had the highest use rate (13.5%) among new technologies; patients reported using them mostly for blood glucose monitoring, physical activity, and nutritional programs. Patients' satisfaction was higher for modern technologies than for conventional methods. Conclusion: The results indicate that awareness of the new technologies used in managing diabetes was higher than their use. Moreover, the use of modern technologies improved the satisfaction of patients.

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Clinical impact of an integrated e-health system for diabetes self-management support and shared decision making (POWER2DM): a randomised controlled trial

Ruissen,

Torres-Peña,

Uitbeijerse

et al. 2023

Diabetologia

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Aims/hypothesis There is a lack of e-health systems that integrate the complex variety of aspects relevant for diabetes self-management. We developed and field-tested an e-health system (POWER2DM) that integrates medical, psychological and behavioural aspects and connected wearables to support patients and healthcare professionals in shared decision making and diabetes self-management. Methods Participants with type 1 or type 2 diabetes (aged >18 years) from hospital outpatient diabetes clinics in the Netherlands and Spain were randomised using randomisation software to POWER2DM or usual care for 37 weeks. This RCT assessed the change in HbA1c between the POWER2DM and usual care groups at the end of the study (37 weeks) as a primary outcome measure. Participants and clinicians were not blinded to the intervention. Changes in quality of life (QoL) (WHO-5 Well-Being Index [WHO-5]), diabetes self-management (Diabetes Self-Management Questionnaire – Revised [DSMQ-R]), glycaemic profiles from continuous glucose monitoring devices, awareness of hypoglycaemia (Clarke hypoglycaemia unawareness instrument), incidence of hypoglycaemic episodes and technology acceptance were secondary outcome measures. Additionally, sub-analyses were performed for participants with type 1 and type 2 diabetes separately. Results A total of 226 participants participated in the trial (108 with type 1 diabetes; 118 with type 2 diabetes). In the POWER2DM group (n=111), HbA1c decreased from 60.6±14.7 mmol/mol (7.7±1.3%) to 56.7±12.1 mmol/mol (7.3±1.1%) (means ± SD, p<0.001), compared with no change in the usual care group (n=115) (baseline: 61.7±13.7 mmol/mol, 7.8±1.3%; end of study: 61.0±12.4 mmol/mol, 7.7±1.1%; p=0.19) (between-group difference 0.24%, p=0.008). In the sub-analyses in the POWER2DM group, HbA1c in participants with type 2 diabetes decreased from 62.3±17.3 mmol/mol (7.9±1.6%) to 54.3±11.1 mmol/mol (7.1±1.0%) (p<0.001) compared with no change in HbA1c in participants with type 1 diabetes (baseline: 58.8±11.2 mmol/mol [7.5±1.0%]; end of study: 59.2±12.7 mmol/mol [7.6±1.2%]; p=0.84). There was an increase in the time during which interstitial glucose levels were between 3.0 and 3.9 mmol/l in the POWER2DM group, but no increase in clinically relevant hypoglycaemia (interstitial glucose level below 3.0 mmol/l). QoL improved in participants with type 1 diabetes in the POWER2DM group compared with the usual care group (baseline: 15.7±3.8; end of study: 16.3±3.5; p=0.047 for between-group difference). Diabetes self-management improved in both participants with type 1 diabetes (from 7.3±1.2 to 7.7±1.2; p=0.002) and those with type 2 diabetes (from 6.5±1.3 to 6.7±1.3; p=0.003) within the POWER2DM group. The POWER2DM integrated e-health support was well accepted in daily life and no important adverse (or unexpected) effects or side effects were observed. Conclusions/interpretation POWER2DM improves HbA1c levels compared with usual care in those with type 2 diabetes, improves QoL in those with type 1 diabetes, improves diabetes self-management in those with type 1 and type 2 diabetes, and is well accepted in daily life. Trial registration ClinicalTrials.gov NCT03588104. Funding This study was funded by the European Union’s Horizon 2020 Research and Innovation Programme (grant agreement number 689444). Graphical Abstract

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Effects of mobile health interventions on improving glycemic stability and quality of life in patients with type 1 diabetes: A meta‐analysis

Cited by 8 publications

References 74 publications

Pandemic-Related Impairment in the Monitoring of Patients With Hypertension and Diabetes and the Development of a Digital Solution for the Community Health Worker: Quasiexperimental and Implementation Study

Pandemic-Related Impairment in the Monitoring of Patients With Hypertension and Diabetes and the Development of a Digital Solution for the Community Health Worker: Quasiexperimental and Implementation Study

Diabetic Patients' Perspective About New Technologies Used in Managing Diabetes Mellitus in Saudi Arabia: A Cross-Sectional Study

Clinical impact of an integrated e-health system for diabetes self-management support and shared decision making (POWER2DM): a randomised controlled trial

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