scholarly journals Continuous Glucose Monitoring in the Real World Using Photosurveillance of #Dexcom on Instagram: Exploratory Mixed Methods Study

10.2196/11024 ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e11024 ◽  
Author(s):  
Michelle L Litchman ◽  
Sarah E Wawrzynski ◽  
Whitney S Woodruff ◽  
Joseph B Arrington ◽  
Quynh C Nguyen ◽  
...  
2018 ◽  
Author(s):  
Michelle L Litchman ◽  
Sarah E Wawrzynski ◽  
Whitney S Woodruff ◽  
Joseph B Arrington ◽  
Quynh C Nguyen ◽  
...  

BACKGROUND Individuals with diabetes are using social media as a method to share and gather information about their health via the diabetes online community. Infoveillance is one methodological approach to examine health care trends. However, infoveillance, while very effective in identifying many real-world health trends, may miss opportunities that use photographs as primary sources for data. We propose a new methodology, photosurveillance, in which photographs are analyzed to examine real-world trends. OBJECTIVE The purpose of this research is to (1) assess the use of photosurveillance as a research method to examine real-world trends in diabetes and (2) report on real-world use of continuous glucose monitoring (CGM) on Instagram. METHODS This exploratory mixed methods study examined all photographs posted on Instagram that were identified with the hashtag #dexcom over a 3-month period—December 2016 to February 2017. Photographs were coded by CGM location on the body. Original posts and corresponding comments were textually coded for length of CGM device wear and CGM failure and were analyzed for emerging themes. RESULTS A total of 2923 photographs were manually screened; 12.08% (353/2923) depicted a photograph with a CGM site location. The majority (225/353, 63.7%) of the photographs showed a CGM site in an off-label location, while 26.2% (92/353) were in an FDA-approved location (ie, abdomen) and 10.2% (36/353) were in an unidentifiable location. There were no significant differences in the number of likes or comments based on US Food and Drug Administration (FDA) approval. Five themes emerged from the analysis of original posts (N=353) and corresponding comments (N=2364): (1) endorsement of CGM as providing a sense of well-being; (2) reciprocating information, encouragement, and support; (3) reciprocating CGM-related frustrations; (4) life hacks to optimize CGM use; and (5) sharing and learning about off-label CGM activity. CONCLUSIONS Our results indicate that individuals successfully used CGM in off-label locations, posting photos of these areas with greater frequency than of the abdomen, with no indication of sensor failure. While these photographs only capture a snapshot in time, these posts can be used to inform providers and industry leaders of real-world trends in CGM use. Additionally, there were instances in which sensors were worn beyond the FDA-approved 7-day period; however, they represented the minority in this study.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 878-P
Author(s):  
KATHERINE TWEDEN ◽  
SAMANWOY GHOSH-DASTIDAR ◽  
ANDREW D. DEHENNIS ◽  
FRANCINE KAUFMAN

2020 ◽  
Vol 22 (8) ◽  
pp. 602-612
Author(s):  
Dirk Sandig ◽  
Julia Grimsmann ◽  
Christina Reinauer ◽  
Andreas Melmer ◽  
Stefan Zimny ◽  
...  

2020 ◽  
Author(s):  
Alexander Perlmutter ◽  
Mehdi Benchoufi ◽  
Philippe Ravaud ◽  
Viet-Thi Tran

BACKGROUND Biometric monitoring devices (BMDs) are wearable or environmental trackers and devices with embedded sensors that can remotely collect high-frequency objective data on patients’ physiological, biological, behavioral, and environmental contexts (for example, fitness trackers with accelerometer). The real-world effectiveness of interventions using biometric monitoring devices depends on patients’ perceptions of these interventions. OBJECTIVE We aimed to systematically review whether and how recent randomized controlled trials (RCTs) evaluating interventions using BMDs assessed patients’ perceptions toward the intervention. METHODS We systematically searched PubMed (MEDLINE) from January 1, 2017, to December 31, 2018, for RCTs evaluating interventions using BMDs. Two independent investigators extracted the following information: (1) whether the RCT collected information on patient perceptions toward the intervention using BMDs and (2) if so, what precisely was collected, based on items from questionnaires used and/or themes and subthemes identified from qualitative assessments. The two investigators then synthesized their findings in a schema of patient perceptions of interventions using BMDs. RESULTS A total of 58 RCTs including 10,071 participants were included in the review (the median number of randomized participants was 60, IQR 37-133). BMDs used in interventions were accelerometers/pedometers (n=35, 60%), electrochemical biosensors (eg, continuous glucose monitoring; n=18, 31%), or ecological momentary assessment devices (eg, carbon monoxide monitors for smoking cessation; n=5, 9%). Overall, 26 (45%) trials collected information on patient perceptions toward the intervention using BMDs and allowed the identification of 76 unique aspects of patient perceptions that could affect the uptake of these interventions (eg, relevance of the information provided, alarm burden, privacy and data handling, impact on health outcomes, independence, interference with daily life). Patient perceptions were unevenly collected in trials. For example, only 5% (n=3) of trials assessed how patients felt about privacy and data handling aspects of the intervention using BMDs. CONCLUSIONS Our review showed that less than half of RCTs evaluating interventions using BMDs assessed patients’ perceptions toward interventions using BMDs. Trials that did assess perceptions often only assessed a fraction of them. This limits the extrapolation of the results of these RCTs to the real world. We thus provide a comprehensive schema of aspects of patient perceptions that may affect the uptake of interventions using BMDs and which should be considered in future trials. CLINICALTRIAL PROSPERO CRD42018115522; https://tinyurl.com/y5h8fjgx


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