1 Gather Health LLC , Hong Kong .
2 NJK Consulting , Seattle, WA.
Telemed J E Health. 2017 Sep;23(9):733-740. doi: 10.1089/tmj.2016.0265. Epub 2017 Mar 6.
In 2015, India had an estimated 69.2 million people with diabetes and a national prevalence of 8.7%. Evidence is mounting for the benefits of telemedicine in diabetes care, but remains limited on mobile-health (m-Health) interventions.
This study assessed the impact of an m-Health diabetes platform on clinical outcomes, patient-reported outcomes, patient and provider satisfaction, and app usage.
This open-label, two-arm parallel study enrolled 91 people at 3 sites in India, aged 18-65, with type 2 diabetes, and an A1c between 7.5% and 12.5% (58-113 mmol/mol). Participants were randomly assigned 1:1 to m-Health or usual care and observed for 6 months. All received free visits, laboratory tests, transportation fees, and strips and lancets. Intervention participants received the m-Health app and a mobile phone data stipend.
A1c change was previously reported as statistically significant. Significantly more participants in intervention than control had improved medication adherence (39.0% vs. 12.8%; p = 0.03) and increased frequency of blood glucose (BG) self-testing (39.0% vs. 10.3%; p = 0.01) at 6 months from baseline. No other outcomes were significantly different. Among m-Health users, 75% of participants actively used the app at week 24. Participants entered 29,668 medications and 2,575 BG readings, sent 497 messages, and received 890 messages. Most participants (80%) were satisfied with all aspects of the app and all seven providers rated the software very acceptable.
Participants assigned to m-Health had increased medication adherence and frequency of BG testing compared with usual care participants.
This tool could be an effective way to expand access to quality chronic disease care and improve outcomes.
2015 年，印度估计有 6920 万人患有糖尿病，患病率为 8.7%。越来越多的证据表明远程医疗在糖尿病护理中的益处，但移动医疗（mHealth）干预措施的证据仍然有限。
本研究评估了 mHealth 糖尿病平台对临床结果、患者报告结果、患者和提供者满意度以及应用程序使用情况的影响。
这项开放标签、双臂平行研究在印度的 3 个地点招募了 91 名年龄在 18-65 岁之间、患有 2 型糖尿病且 A1c 在 7.5%至 12.5%（58-113mmol/mol）之间的患者。参与者被随机分为 1:1 组接受 mHealth 或常规护理，并观察 6 个月。所有参与者都获得了免费的就诊、实验室检查、交通费以及试纸和采血针。
A1c 的变化先前已被报道为具有统计学意义。与对照组相比，干预组有更多的参与者改善了药物治疗的依从性（39.0%比 12.8%；p=0.03），并且增加了血糖（BG）自我检测的频率（39.0%比 10.3%；p=0.01），从基线到 6 个月。其他结果没有显著差异。在 mHealth 用户中，75%的参与者在第 24 周时积极使用该应用程序。参与者输入了 29668 种药物和 2575 次 BG 读数，发送了 497 条消息，接收了 890 条消息。大多数参与者（80%）对应用程序的所有方面都非常满意，所有 7 位提供者都对该软件的评价非常高。
与常规护理组相比，分配到 mHealth 的参与者在药物治疗的依从性和 BG 检测的频率上有所增加。
这个工具可以成为扩大获得高质量慢性病护理和改善结果的有效途径。
