National Institute for Health Innovation, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
JMIR Mhealth Uhealth. 2015 Mar 25;3(1):e32. doi: 10.2196/mhealth.3988.
The increasing prevalence of diabetes and costly long-term complications associated with poor glycemic control are issues facing health services worldwide. Diabetes self-management, with the support of health care providers, is critical for successful outcomes, however, frequent clinical contact is costly. Text messages via short message service (SMS) have the advantage of instant transmission at low cost and, given the ubiquity of mobile phones, may be the ideal platform for the delivery of diabetes self-management support. A tailored text message-based diabetes support intervention called Self-Management Support for Blood Glucose (SMS4BG) was developed. The intervention incorporates prompts around diabetes education, management, and lifestyle factors (healthy eating, exercise, and stress management), as well as blood glucose monitoring reminders, and is tailored to patient preferences and clinical characteristics.
To determine the usability and acceptability of SMS4BG among adults with poorly controlled diabetes.
Adults (aged 17 to 69 years) with type 1 (n=12) or type 2 diabetes (n=30), a hemoglobin A1c (HbA1c) over 70 mmol/mol (8.6%), and who owned a mobile phone (n=42) were recruited to take part in a 3-month pilot study of SMS4BG. At registration, participants selected the modules they would like to receive and, where appropriate, the frequency and timing of blood glucose monitoring reminders. Patient satisfaction and perceptions of the usability of the program were obtained via semistructured phone interviews conducted at completion of the pilot study. HbA1c was obtained from patient records at baseline and completion of the pilot study.
Participants received on average 109 messages during the 3-month program with 2 participants withdrawing early from the study. Follow-up interviews were completed with 93% of participants with all reporting SMS4BG to be useful and appropriate to their age and culture. Participants reported a range of perceived positive impacts of SMS4BG on their diabetes and health behaviors. HbA1c results indicated a positive impact of the program on glycemic control with a significant decrease in HbA1c from baseline to follow-up.
A tailored text message-based intervention is both acceptable and useful in supporting self-management in people with poorly controlled diabetes. A randomized controlled trial of longer duration is needed to assess the efficacy and sustainability of SMS4BG.
糖尿病发病率不断上升，以及血糖控制不佳导致的长期并发症费用高昂，是全球卫生服务面临的问题。在医疗保健提供者的支持下进行糖尿病自我管理对于取得成功至关重要，然而，频繁的临床接触成本高昂。短信服务（SMS）发送的文本消息具有成本低廉、即时传输的优势，而且考虑到手机的普及，它可能是提供糖尿病自我管理支持的理想平台。开发了一种名为“血糖自我管理支持的短信（SMS4BG）”的定制短信为基础的糖尿病支持干预措施。该干预措施围绕糖尿病教育、管理和生活方式因素（健康饮食、运动和压力管理）以及血糖监测提醒，结合患者的偏好和临床特征。
确定 SMS4BG 在血糖控制不佳的成年人中的可用性和可接受性。
招募了 12 名 1 型和 30 名 2 型糖尿病（HbA1c 超过 70 mmol/mol（8.6%）的成年人），年龄在 17 至 69 岁之间，拥有移动电话（n=42）参加了 SMS4BG 的 3 个月试点研究。在注册时，参与者选择他们希望接收的模块，以及在适当的情况下，血糖监测提醒的频率和时间。通过在试点研究结束时进行半结构化电话访谈，获得患者对该计划的满意度和对其可用性的看法。基线和试点研究结束时从患者记录中获得 HbA1c。
参与者在 3 个月的计划中平均收到 109 条消息，其中 2 名参与者提前退出研究。对 93%的参与者进行了随访访谈，他们都表示 SMS4BG 对他们的年龄和文化有用且合适。参与者报告了 SMS4BG 对他们的糖尿病和健康行为产生的一系列积极影响。HbA1c 结果表明该计划对血糖控制有积极影响，HbA1c 从基线到随访有显著下降。
定制短信为基础的干预措施在支持血糖控制不佳的人群自我管理方面既可以接受又有用。需要进行更长期的随机对照试验来评估 SMS4BG 的疗效和可持续性。
