scholarly journals My Diabetes Coach, a Mobile App–Based Interactive Conversational Agent to Support Type 2 Diabetes Self-Management: Randomized Effectiveness-Implementation Trial (Preprint)

2020 ◽  
Author(s):  
Enying Gong ◽  
Shaira Baptista ◽  
Anthony Russell ◽  
Paul Scuffham ◽  
Michaela Riddell ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Controlled Trial ◽  
Care Program ◽  
Mobile App ◽  
Self Management ◽  
Management Support ◽  
Conversational Agent ◽  
Home Setting ◽  
And Control

BACKGROUND Delivering self-management support to people with type 2 diabetes mellitus is essential to reduce the health system burden and to empower people with the skills, knowledge, and confidence needed to take an active role in managing their own health. OBJECTIVE This study aims to evaluate the adoption, use, and effectiveness of the My Diabetes Coach (MDC) program, an app-based interactive embodied conversational agent, <i>Laura</i>, designed to support diabetes self-management in the home setting over 12 months. METHODS This randomized controlled trial evaluated both the implementation and effectiveness of the MDC program. Adults with type 2 diabetes in Australia were recruited and randomized to the intervention arm (MDC) or the control arm (usual care). Program use was tracked over 12 months. Coprimary outcomes included changes in glycated hemoglobin (HbA<sub>1c</sub>) and health-related quality of life (HRQoL). Data were assessed at baseline and at 6 and 12 months, and analyzed using linear mixed-effects regression models. RESULTS A total of 187 adults with type 2 diabetes (mean 57 years, SD 10 years; 41.7% women) were recruited and randomly allocated to the intervention (n=93) and control (n=94) arms. MDC program users (92/93 participants) completed 1942 chats with <i>Laura</i>, averaging 243 min (SD 212) per person over 12 months. Compared with baseline, the mean estimated HbA<sub>1c</sub> decreased in both arms at 12 months (intervention: 0.33% and control: 0.20%), but the net differences between the two arms in change of HbA<sub>1c</sub> (−0.04%, 95% CI −0.45 to 0.36; <i>P</i>=.83) was not statistically significant. At 12 months, HRQoL utility scores improved in the intervention arm, compared with the control arm (between-arm difference: 0.04, 95% CI 0.00 to 0.07; <i>P</i>=.04). CONCLUSIONS The MDC program was successfully adopted and used by individuals with type 2 diabetes and significantly improved the users’ HRQoL. These findings suggest the potential for wider implementation of technology-enabled conversation-based programs for supporting diabetes self-management. Future studies should focus on strategies to maintain program usage and HbA<sub>1c</sub> improvement. CLINICALTRIAL Australia New Zealand Clinical Trials Registry (ACTRN) 12614001229662; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614001229662

scholarly journals My Diabetes Coach, a Mobile App–Based Interactive Conversational Agent to Support Type 2 Diabetes Self-Management: Randomized Effectiveness-Implementation Trial

10.2196/20322 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e20322
Author(s):  
Enying Gong ◽  
Shaira Baptista ◽  
Anthony Russell ◽  
Paul Scuffham ◽  
Michaela Riddell ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Controlled Trial ◽  
Mobile App ◽  
Trial Registration ◽  
Self Management ◽  
Management Support ◽  
Conversational Agent ◽  
Home Setting ◽  
And Control

Background Delivering self-management support to people with type 2 diabetes mellitus is essential to reduce the health system burden and to empower people with the skills, knowledge, and confidence needed to take an active role in managing their own health. Objective This study aims to evaluate the adoption, use, and effectiveness of the My Diabetes Coach (MDC) program, an app-based interactive embodied conversational agent, Laura, designed to support diabetes self-management in the home setting over 12 months. Methods This randomized controlled trial evaluated both the implementation and effectiveness of the MDC program. Adults with type 2 diabetes in Australia were recruited and randomized to the intervention arm (MDC) or the control arm (usual care). Program use was tracked over 12 months. Coprimary outcomes included changes in glycated hemoglobin (HbA1c) and health-related quality of life (HRQoL). Data were assessed at baseline and at 6 and 12 months, and analyzed using linear mixed-effects regression models. Results A total of 187 adults with type 2 diabetes (mean 57 years, SD 10 years; 41.7% women) were recruited and randomly allocated to the intervention (n=93) and control (n=94) arms. MDC program users (92/93 participants) completed 1942 chats with Laura, averaging 243 min (SD 212) per person over 12 months. Compared with baseline, the mean estimated HbA1c decreased in both arms at 12 months (intervention: 0.33% and control: 0.20%), but the net differences between the two arms in change of HbA1c (−0.04%, 95% CI −0.45 to 0.36; P=.83) was not statistically significant. At 12 months, HRQoL utility scores improved in the intervention arm, compared with the control arm (between-arm difference: 0.04, 95% CI 0.00 to 0.07; P=.04). Conclusions The MDC program was successfully adopted and used by individuals with type 2 diabetes and significantly improved the users’ HRQoL. These findings suggest the potential for wider implementation of technology-enabled conversation-based programs for supporting diabetes self-management. Future studies should focus on strategies to maintain program usage and HbA1c improvement. Trial Registration Australia New Zealand Clinical Trials Registry (ACTRN) 12614001229662; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614001229662

scholarly journals Mobile App for Improved Self-Management of Type 2 Diabetes: Multicenter Pragmatic Randomized Controlled Trial

10.2196/10321 ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. e10321 ◽  
Author(s):  
Payal Agarwal ◽  
Geetha Mukerji ◽  
Laura Desveaux ◽  
Noah M Ivers ◽  
Onil Bhattacharyya ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Mobile App ◽  
Self Management ◽  
Pragmatic Randomized Controlled Trial ◽  
Randomized Controlled

scholarly journals Effectiveness of a self-management support program for type 2 diabetes patients in the first years of illness: Results from a randomized controlled trial

PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0218242 ◽  
Author(s):  
Anne L. van Puffelen ◽  
Mieke Rijken ◽  
Monique J. W. M. Heijmans ◽  
Giel Nijpels ◽  
François G. Schellevis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Support Program ◽  
Self Management ◽  
Management Support ◽  
Randomized Controlled ◽  
Diabetes Patients

Efficacy of a self-management education programme on patients with type 2 diabetes in primary care: A randomised controlled trial

2019 ◽  
Vol 13 (2) ◽  
pp. 122-133 ◽  
Author(s):  
Estibaliz Gamboa Moreno ◽  
Maider Mateo-Abad ◽  
Lourdes Ochoa de Retana García ◽  
Kalliopi Vrotsou ◽  
Emma del Campo Pena ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Randomised Controlled Trial ◽  
Management Education ◽  
Controlled Trial ◽  
Education Programme ◽  
Self Management ◽  
Randomised Controlled

scholarly journals Digital Person-Centered Self-Management Support for People With Type 2 Diabetes: Qualitative Study Exploring Design Challenges

JMIR Diabetes ◽  
10.2196/10702 ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. e10702
Author(s):  
Robyn Schimmer ◽  
Carljohan Orre ◽  
Ulrika Öberg ◽  
Karin Danielsson ◽  
Åsa Hörnsten
Keyword(s):  
Type 2 Diabetes ◽  
Digital Health ◽  
Work Practice ◽  
Current Work ◽  
Self Management ◽  
Substantial Part ◽  
Management Support ◽  
Design Decisions ◽  
Ehealth Service

Background Self-management is a substantial part of treatment for patients with type 2 diabetes (T2D). Modern digital technology, being small, available, and ubiquitous, might work well in supporting self-management. This study follows the process of developing a pilot implementation of an electronic health (eHealth) service for T2D self-management support in primary health care. The use of digital health, or eHealth, solutions for supporting self-management for patients with T2D is increasing. There are good examples of successful implementations that can serve as guides in the development of new solutions. However, when adding person-centered principles as a requirement, the examples are scarce. Objective The objective of this study was to explore challenges that could impact the design of a person-centered eHealth service for T2D self-management support. The study included data collection from multiple sources, that is, interviews, observations, focus groups, and a Mentimeter (interactive presentation with polling) survey among stakeholders, representing various perspectives of T2D. Methods A user-centered design approach was used to exploratively collect data from different sources. Data were collected from a workshop, interviews, and observations. The different data sources enabled a triangulation of data. Results Results show that user needs related to an eHealth service for person-centered T2D self-management support are multifaceted and situated in a complex context. The two main user groups, patients and diabetes specialist nurses, express needs that both diverge and converge, which indicates that critical design decisions have to be made. There is also a discrepancy between the needs expressed by the potential users and the current work practice, suggesting more attention toward changing the organization of work to fully support a new eHealth service. Conclusions A total of three overarching challenges—flexible access, reducing administrative tasks, and patient empowerment—each having a significant impact on design, are discussed. These challenges need to be considered and resolved through careful design decisions. Special attention has to be given to the patient user group that could greatly impact current work practice and power structures at the primary care unit. A need for further studies investigating patient needs in everyday life is identified to better support the implementation of technology that does not give specific attention to organizational perspectives but instead approach design with the patient perspective in focus.

scholarly journals Efektivitas Mobile Health Intervention Terhadap Manajemen Diri Dan Kontrol Glikemik Pada Pasien Dengan Diabtes Melitus Tipe 2: A Systematic Review

2020 ◽  
Vol 11 (4) ◽  
pp. 342
Author(s):  
Wahyu Sukma Samudera ◽  
Novita Fajriyah ◽  
Ida Trisnawati
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Mobile Health ◽  
Controlled Trial ◽  
Health Intervention ◽  
Self Management ◽  
Diabetes Melitus

Background: Type 2 diabetes mellitus was one of non-communicable diseases that increased of prevalence in word wide, included in Indonesia. Utilization of technology as an effort of increase of diabetes treatment is important for achieving of optimum glycemic control and to prevent of complication of diabetes mellitus. However, intervention for self management in patients with diabetes mellitus at this time still not using technology based mobile health intervention. Purpose: This study aims to verify of effectiveness of mobile health intervention on self management and glycemic control in patient with type 2 diabetes mellitus. Method: Design of this studies was used systematic review of randomized controlled trial with PRISMA approach. Article search was carried out through databases: Scopus, Science Direct, and ProQuest with randomized controlled trial design within last 10 years. Results: The finding showed 407 articles have been obtained. Articles selection process were through few steps: topic selection, full text selection, design of studies and obtained 10 articles have been as appropriate of inclusion criteria. Based on results of finding of 10 articles were showed that mobile health intervention was effective in improving of glycemic control by decreasing hbA1c, fasting blood glucose, 2 hours post pandrial. Furthermore, mobile health intervention was effective in increasing of self management in patient with type 2 diabetes mellitus and increased adherence of diabetes medication. Moreover, mobile health intervention can also improve of insulin level and lipid profile in patient with type 2 diabetes mellitus. Conclusion: Mobile health intervention was effective in improving of glycemic control and self management, and giving of facilitate communication between patient and health providers Keywords: mobile health application; self management; glycemic control; diabetes mellitus ABSTRAK Latar belakang: diabetes melitus (DM) tipe 2 merupakan salah satu penyakit tidak menular yang mengalami peningkatan angka kejadian di dunia, termasuk di Indonesia. Penggunaan teknologi sebagai upaya meningkatkan manajemen diabetes melitus sangatlah penting untuk dilakukan guna mencapai kontrol glikemik optimal dan mencegah komplikasi dari Diabetes Melitus. Namun, manajemen diri pada sebagian besar pasien Diabetes Melitus saat ini masih belum menggunakan bantuan teknologi berbasis mobile health. Tujuan: Penelitian ini bertujuan untuk memverifikasi efektivitas dari penggunaan mobile health intervention terhadap manajemen diri dan kontrol glikemik pasien dengan diabetes melitus tipe 2. Metode: desain dalam penelitian ini adalah systematic review dengan menggunakan pendekatan PRISMA. Pencarian artikel dilakukan pada beberapa database yang meliputi: Scopus, Science Direct dan ProQuest dengan desain Randomized controlled trial dalam 10 tahun terakhir. Hasil: hasil temuan didapatkan sejumlah 407 artikel penelitian. Proses seleksi artikel dilakukan beberapa tahap meliputi: seleksi topik, fullteks, desain artikel penelitian dan didapatkan 10 artikel penelitian yang sesuai dengan kriteria inklusi. Berdasarkan hasil temuan dari 10 artikel penelitian yang digunakan, menunjukkan bahwa mobile health intervention efektif dalam memperbaiki kontrol glikemik pasien diabetes melalui penurunan kadar hbA1c, gula darah puasa, 2 jam post pandrial. Selanjutnya, mobile health intervention efektif dalam meningkatkan manajemen diri pasien diabetes dan meningkatkan kepatuhan pengobatan. Selain itu, mobile health intervention juga dapat memperbaiki level insulin dan profil lipid pasien diabetes melitus tipe 2. Kesimpulan: Mobile health intervention efektif dalam memperbaiki kontrol glikemik dan meningkatkan manajemen diri pasien diabetes melitus serta memudahkan komunikasi antara pasien dengan tenaga kesehatan Kata kunci: mobile health application; manajemen diri; kontrol glikemik; diabetes melitus

Sign in / Sign up

Export Citation Format

Share Document