The effect of an mHealth intervention for titration of insulin for type 2 diabetes: A pilot study.

Bramwell, SE; Meyerowitz-Katz, G; Ferguson, C; Jayaballa, R; McLean, M; Maberly, G

The effect of an mHealth intervention for titration of insulin for type 2 diabetes: A pilot study.

Bramwell, SE Meyerowitz-Katz, G Ferguson, C

Jayaballa, R McLean, M Maberly, G

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Publisher:: SAGE PUBLICATIONS LTD
Publication Type:: Journal Article
Citation:: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 2020, 19, (5), pp. 386-392
Issue Date:: 2020-06

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Field	Value	Language
dc.contributor.author	Bramwell, SE
dc.contributor.author	Meyerowitz-Katz, G
dc.contributor.author	Ferguson, C https://orcid.org/0000-0002-2417-2216
dc.contributor.author	Jayaballa, R
dc.contributor.author	McLean, M
dc.contributor.author	Maberly, G
dc.date.accessioned	2020-09-24T05:48:25Z
dc.date.available	2020-09-24T05:48:25Z
dc.date.issued	2020-06
dc.identifier.citation	European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 2020, 19, (5), pp. 386-392
dc.identifier.issn	1474-5151
dc.identifier.issn	1873-1953
dc.identifier.uri	http://hdl.handle.net/10453/142850
dc.description.abstract	BACKGROUND:Stabilising blood glucose levels (BGL) after starting or changing insulin and related therapies can be challenging for diabetes services and the patient with type 2 diabetes. Traditionally, a credentialled diabetes educator (CDE) would talk with the patient over the phone to obtain a history of their BGLs over the previous week and provide advice on the insulin dose adjustments as required. This study trialled a smartphone application for sharing BGLs, with the ability to digitally transmit advice back to patients compared with their usual care. AIMS:The aim of this study was to compare desirability, efficiency and ease of use. METHODS:Participants were enrolled in either the traditional (n=50) or Health2Sync (H2S) (n=42) treatment group by patient preference. All insulin stabilisations were conducted by the CDE. Descriptive statistics were used for analysis. RESULTS:The average total time taken to titrate patients was similar in both groups (p>0.05), however there were fewer failure of contacts reported with H2S (p<0.01) and time per interaction was also lower (p<0.01). Sensitivity analysis revealed that, excluding the influence of no contacts, H2S patients had a lower average time for titration (p<0.01). There was no difference in clinical outcomes as measured by HbA1c between the two groups (p=0.75). CONCLUSION:We demonstrated a high acceptance and clinical utility of the H2S application. Clinicians were happy to use H2S and found it easy and convenient for most patients. Importantly, this reduced frequency of contacts with patients, time per interaction and average time for titration (p<0.01). Patient selection for this communication intervention is important.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	SAGE PUBLICATIONS LTD
dc.relation.ispartof	European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology
dc.relation.isbasedon	10.1177/1474515119889764
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology, 1110 Nursing, 1117 Public Health and Health Services
dc.subject.classification	Nursing
dc.title	The effect of an mHealth intervention for titration of insulin for type 2 diabetes: A pilot study.
dc.type	Journal Article
utslib.citation.volume	19
utslib.location.activity	England
utslib.for	1102 Cardiorespiratory Medicine and Haematology
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2020-09-24T05:48:22Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	19
utslib.citation.issue	5

Abstract:

BACKGROUND:Stabilising blood glucose levels (BGL) after starting or changing insulin and related therapies can be challenging for diabetes services and the patient with type 2 diabetes. Traditionally, a credentialled diabetes educator (CDE) would talk with the patient over the phone to obtain a history of their BGLs over the previous week and provide advice on the insulin dose adjustments as required. This study trialled a smartphone application for sharing BGLs, with the ability to digitally transmit advice back to patients compared with their usual care. AIMS:The aim of this study was to compare desirability, efficiency and ease of use. METHODS:Participants were enrolled in either the traditional (n=50) or Health2Sync (H2S) (n=42) treatment group by patient preference. All insulin stabilisations were conducted by the CDE. Descriptive statistics were used for analysis. RESULTS:The average total time taken to titrate patients was similar in both groups (p>0.05), however there were fewer failure of contacts reported with H2S (p<0.01) and time per interaction was also lower (p<0.01). Sensitivity analysis revealed that, excluding the influence of no contacts, H2S patients had a lower average time for titration (p<0.01). There was no difference in clinical outcomes as measured by HbA1c between the two groups (p=0.75). CONCLUSION:We demonstrated a high acceptance and clinical utility of the H2S application. Clinicians were happy to use H2S and found it easy and convenient for most patients. Importantly, this reduced frequency of contacts with patients, time per interaction and average time for titration (p<0.01). Patient selection for this communication intervention is important.

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http://hdl.handle.net/10453/142850