246335 Formative Development of a Web-based Diabetes Medication Adherence Dashboard

Monday, October 31, 2011

Richard Goldsworthy, MSEd, PhD , Academic Edge, Inc., Bloomington, IN
David Marrero, PhD , Director, Diabetes Translational Research Center, Division of Endocrinology & Metabolism, Indiana University School of Medicine, Indianapolis
Background Diabetes affects over 24 million individuals in the U.S. Understanding of ideal patient and provider diabetes management practices has significantly improved; however, optimal diabetes care behaviors are often not achieved in real-world clinical experiences as a result of personal, environmental, and sociotechnical barriers. Two such barriers to patient self-management and regimen adherence are inefficient communication and lack of clinical “facetime.” Web-based patient dashboards, with management, information, and education resources may help, yet for diabetes care generally, and medication adherence specifically, these tools have remained unexplored.

Objective: To develop and evaluate research-based, theory-grounded diabetes management tools, including a patient dashboard and related educational and performance support tools, to improve diabetes patient understanding, self-management, and provider communication.

Methods: Dashboard and supporting resource development occurred through a well-established, iterative, user-centered process, with input and ongoing formative review by a panel of experienced subject-matter experts, high performing practitioners, and diabetes patients, and a mixed methods pilot evaluation within components of a large multi-organizational system.

Results: We developed an EMR-integrated dashboard, patient self-assessment/self-management tools, and self-tailorable, adaptive, learning resources ranging from an interactive FAQ, to animated segments, to video cases. Formative evaluation participants found the system usable, useful, and engaging; indicated it would make it easier for them to manage medication adherence and to actually adhere to their diabetes treatment regimen; and provided numerous suggestions for modification and extension.

Discussion: Diabetes medication adherence is a recalcitrant problem. This effort demonstrated that a diabetes dashboard can mitigate some barriers for some patients, potentially leading to better care outcomes. Several challenges arose. Next steps include refining the tools and evaluating the system in a longitudinal field trial. This presentation will describe the development process; demonstrate dashboard components and resources; and discuss the formative evaluation, implications, and future work.

Supported in part by NIH Challenge Grant #1RC1LM010484-01

Learning Areas:
Communication and informatics
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
Participants will be able to: describe the functionality and technological architecture of a patient dashboard to support diabetic patient medication adherence describe development and evaluation of patient diabetes adherence-related educational materials integrated within the dashboard assess the value of the dashboard and related resources for their own diabetes or technological/educational/patient support efforts discuss positive outcomes, limitations, and challenges related to the effort

Keywords: Diabetes, Adherence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 15 years experience as principle investigator and lead researcher on a variety of public health educational and behavioral change effort. I am presently the principle investigator on the large scale NIH challenge grant supporting the research described in this abstract. My colleague is a nationally recognized expert in diabetes management and in technological efforts to augment care.
Any relevant financial relationships? No

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.