145580 Novel Interactive Cell phone technology for Health Enhancement (NICHE)

Wednesday, November 7, 2007

Zubaida Faridi, MBBS, MPH , Prevention Research Center / School of Public Health, Yale University, Derby, CT
Veronika Northrup, MPH , Prevention Research Center / School of Public Health, Yale University, Derby, CT
Lauren S. Liberti, MS , Prevention Research Center / School of Public Health, Yale University, Derby, CT
David L. Katz, MD, MPH , Prevention Research Center / School of Public Health, Yale University, Derby, CT
Kerem Shuval, PhD, MPH , Prevention Research Center, Yale-Griffin Prevention Research Center, Derby, CT
Background: The prevention of complications associated with type 2 diabetes is dependent on diabetes control, of which diabetic self-management is an integral component. Despite the benefits of adhering to a disease management program for diabetes, national compliance to such programs is not optimal. New technologies allow for the practice of tailoring health information as an effective means to change health behaviors.

Purpose: To establish the feasibility and utility of using the key components of the Confidant System in patients with type 2 diabetes.

Methods: Thirty patients with a diagnosis of type 2 diabetes at two Community Health Centers in CT were randomized to an intervention or control group. Participants at the intervention site received the Confidant System technology (Confidant-enabled pedometer, glucometer, and cell phone with remote access daily feedback and reminders) and used it for 3 months. Patients received tailored messages via cell-phone that were developed based on uploaded data. Both the patient and health care providers were able to access readings from uploaded data in table format, and download them into a Microsoft Excel file. Patients at the control site continued with their standard diabetes self-management.

Results: Level of uptake and compliance was 75% in the intervention group. Patient and clinicians considered the system superior to standard care offered. The mean improvement in HbA1c levels was -0.1 ± 0.3%, p=0.1534 in the intervention group, compared to the mean deterioration of 0.3 ± 1.0%, p=0.3813 in the control group. Self-efficacy scores [(total self-efficacy score (-0.5 ± 0.6) and self-treatment efficacy score (-0.6 ± 0.9)] improved significantly in the intervention group.

Conclusion: Tracking clinical data with pertinent, real-time feedback to patients, provided by the Confidant System, improved glycemic control and self efficacy in managing diabetes. Integration of the system into routine care can translate to significant clinical and financial benefits.

Learning Objectives:
1. Develop and implement a diabetes management program to improve glycemic control as measured by HbA1c levels using cell phone technology. 2. List 3 practice changes required to integrate the program into routine care. 3. List 3 feasibility and utility variables to assess effectiveness of diabetes management programs.

Keywords: Health Care Delivery, Disease Management

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Advances in Telemedicine, Compliance Issues, and Overcoming Barriers in Public Health Informatics
See more of: Health Informatics Information Technology