The effectiveness, reproducibility, and durability of tailored mobile coaching on diabetes management in policyholders: A randomized, controlled, open-label study

Abstract

This randomized, controlled, open-label study conducted in Kangbuk Samsung Hospital evaluated the effectiveness, reproducibility, and durability of tailored mobile coaching (TMC) on diabetes management. The participants included 148 Korean adult policyholders with type 2 diabetes divided into the Intervention-Maintenance (I-M) group (n = 74) and Control-Intervention (C-I) group (n = 74). Intervention was the addition of TMC to typical diabetes care. In the 6-month phase 1, the I-M group received TMC, and the C-I group received their usual diabetes care. During the second 6-month phase 2, the C-I group received TMC, and the I-M group received only regular information messages. After the 6-month phase 1, a significant decrease (0.6%) in HbA1c levels compared with baseline values was observed in only the I-M group (from 8.1 ± 1.4% to 7.5 ± 1.1%, P < 0.001 based on a paired t-test). At the end of phase 2, HbA1c levels in the C-I group decreased by 0.6% compared with the value at 6 months (from 7.9 ± 1.5 to 7.3 ± 1.0, P < 0.001 based on a paired t-test). In the I-M group, no changes were observed. Both groups showed significant improvements in frequency of blood-glucose testing and exercise. In conclusion, addition of TMC to conventional treatment for diabetes improved glycemic control, and this effect was maintained without individualized message feedback.

Popular Diabetes Apps and the Impact of Diabetes App Use on Self-Care Behaviour: A Survey Among the Digital Community of Persons With Diabetes on Social Media

“…Randomized control trials and observational studies have shown that using diabetes apps for self-management significantly improves scores of cumulative (40, 56) or individual self-care components (39, 57–59). Blood glucose monitoring (56–59), physical activity (57, 59), general diet (39, 56), specific diet (57–59), and foot care (39, 58) behaviours have been reported to be significantly improved by using diabetes apps. This is mainly due to the reason that diabetes app use may indeed be a useful approach to improve diabetes knowledge, self-management skills, and knowledge about complications which may ultimately enhance self-care practices (60).…”

The Use of Mobile Personal Health Records for Hemoglobin A1c Regulation in Patients With Diabetes: Retrospective Observational Study

“…Another is ensuring a high-quality data analysis is conducted. There are many previous studies implying the advantages of PHRs and PGHD with positive conclusions of the use of mPHRs [ 14 - 17 ]. The results of these studies were collected on the basis of clinical trials such as nonblinded, open-label randomized controlled trials (RCTs) and cluster-randomized trial designs.…”

“…This program was thereafter progressively rolled out to the general public, and it finally achieved universal coverage in 1989. According to the National Health Insurance Act, the criteria for the method, procedure, scope, and upper limit of health care shall be prescribed by the Ministry of Health and Welfare [ 17 ].…”

“…However, the criteria for the comparison group were the same, and despite including and excluding many patient criteria and comparing with the MCMH 1.0 user analysis, the study scale is almost similar [ 22 ]. The size of the continuous user groups is sometimes larger than that used in other RCT studies and had little baseline differences in diabetic severity [ 17 ]. As MCMH version 2.0 data are PGHD, continuous use can only be analyzed by its log data, which does not represent adherence to the app and can lead to information bias.…”

“…A similar improvement in HbA 1c control for type 2 diabetes was seen with another mobile-based intervention [ 16 ]. The addition of a tailored mobile coaching system for patients with diabetes showed reduced HbA 1c levels and improved diabetes self-management; the results were reproducible and durable [ 17 ].…”