Subgroup analyses suggested that organisational interventions and interventions on those with baseline HbA1c over 9.5 % had better improvements in HbA1c .
Interventions had a modest improvement of blood pressure and lipids , although baseline levels of control were generally good .
Conclusions This review suggests that interventions for T2DM , in primary care , are better targeted at individuals with very poor glycaemic control and that organisational interventions may be more effective
Objectives Poorly controlled type 2 diabetes mellitus ( T2DM ) is a major international health problem .
Going Mobile With Diabetes Support: A Randomized Study of a Text Message–Based Personalized Behavioral Intervention for Type 2 Diabetes Self-Care
Objective . Patients with type 2 diabetes often fail to achieve self-management goals . This study tested the impact on glycemic control of a two-way text messaging program that provided behavioral coaching , education , and testing reminders to enrolled individuals with type 2 diabetes in the context of a clinic-based quality improvement initiative . The secondary aim examined patient interaction and satisfaction with the program . Methods . Ninety-three adult patients with poorly controlled type 2 diabetes ( A1C > 8 % ) were recruited from 18 primary care clinics in three counties for a 6-month study . Patients were r and omized by a computer to one of two arms . Patients in both groups continued with their usual care ; patients assigned to the intervention arm also received from one to seven diabetes-related text messages per day depending on the choices they made at enrollment . At 90 and 180 days , A1C data were obtained from the electronic health record and analyzed to determine changes from baseline for both groups . An exit survey was used to assess satisfaction . Enrollment behavior and interaction data were pulled from a Web-based administrative portal maintained by the technology vendor . Results . Patients used the program in a variety of ways . Twenty-nine percent of program users demonstrated frequent engagement ( texting responses at least three times per week ) for a period of ≥90 days . Survey results indicate very high satisfaction with the program . Both groups ’ average A1C decreased from baseline , possibly reflecting a broader quality improvement effort underway in participating clinics . At 90 and 180 days , there was no statistically significant difference between the intervention and control groups in terms of change in A1C ( P > 0.05 ) . Conclusions . This study demonstrated a practical approach to implementing and monitoring a mobile health intervention for self-management support across a wide range of independent clinic practice
Subgroup analyses suggested that organisational interventions and interventions on those with baseline HbA1c over 9.5 % had better improvements in HbA1c .
Interventions had a modest improvement of blood pressure and lipids , although baseline levels of control were generally good .
Conclusions This review suggests that interventions for T2DM , in primary care , are better targeted at individuals with very poor glycaemic control and that organisational interventions may be more effective
Objectives Poorly controlled type 2 diabetes mellitus ( T2DM ) is a major international health problem .