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Observational Study
. 2015 Apr;9(2):127-34.
doi: 10.1016/j.pcd.2014.06.003. Epub 2014 Jul 22.

Improvements in illness self-management and psychological distress associated with telemonitoring support for adults with diabetes

James E Aikens  1 , Ann-Marie Rosland  2 , John D Piette  3
Affiliations
Observational Study

Improvements in illness self-management and psychological distress associated with telemonitoring support for adults with diabetes

James E Aikens et al. Prim Care Diabetes. 2015 Apr.

Abstract

Objective: The objective of this observational open label trial was to characterize changes in diabetes self-management and psychological distress associated with a mobile health (mHealth) interactive voice response (IVR) self-management support program.

Methods: For 3-6 months, 301 patients with diabetes received weekly IVR calls assessing health status and self-care and providing tailored pre-recorded self-management support messages. Patients could participate together with an informal caregiver who received suggestions on self-management support, and patients' clinicians were notified automatically when patients reported significant problems.

Results: Patients completed 84% of weekly calls, providing 5682 patient-weeks of data. Thirty-nine percent participated with an informal caregiver. Outcome analyses adjusted for study design factors and sociodemographics indicated significant pre-post improvement in medication adherence, physical functioning, depressive symptoms, and diabetes-related distress (all p values <0.001). Analyses of self-management problems indicated that as the intervention proceeded, there were significant improvements in patients' IVR-reported frequency of weekly medication adherence, SMBG performance, checking feet, and frequency of abnormal self-monitored blood glucose readings (all p values <0.001).

Conclusions: We conclude that the combined program of automated telemonitoring, clinician notification, and informal caregiver involvement was associated with consistent improvements in medication adherence, diabetes self-management behaviors, physical functioning, and psychological distress. A randomized controlled trial is needed to verify these encouraging findings.

Keywords: Care management; Diabetes; Primary care; mHealth.

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Conflict of interest statement

All authors have read the journal's policy on disclosure of potential conflict of interest. None of the authors have any financial or personal relationship to disclose with organizations that could potentially be perceived as influencing the described research. There are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

Figures

Figure 1
Figure 1
Mean rate of problem occurrence by intervention week.
See this image and copyright information in PMC

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