PHILADELPHIA — Use of a Spanish-language, tablet computer-based communication tool resulted in a higher rate of discussion of CVD risk and changes in medications to treat risk factors in a group of Hispanic adults with type 2 diabetes.
Paris Roach, MD, reported data from a randomized controlled comparison of the intervention, as compared with usual care, at four urban primary care clinics providing care to the local Spanish-speaking Hispanic population.
“The goal was to get patients more involved in their own care so they can understand their risk [for CVD], be activated to discuss risk with their primary care providers, and adopt and adhere to therapies to address their risk factors,” Roach, associate professor of clinical medicine, division of endocrinology, Indiana University School of Medicine, said during an oral session at the American Diabetes Association’s 72nd Scientific Sessions.
The multimedia communication tool consists of a series of 5- to 12-minute video presentations that patients viewed on tablet computers just prior to outpatient visits. Each presentation incorporates individual CVD risk factor data and 10-year CVD risk based on UKPDS Risk Engine Estimates. The tool provides patients with an overview of CVD risk using the patient’s own clinical data, calculates risk and displays risk factors, according to Roach.
The efficacy of the communication tool was studied in 122 Spanish-speaking patients with type 2 diabetes and no known CVD (mean age, 47 years). Each patient had at least one uncontrolled CVD risk factor (LDL ≥130 mg/dL; systolic BP ≥150 mm Hg; HbA1c ≥8%). Patients were assigned to the intervention group or a control group.
Patients in the intervention group (n=72) were exposed to the tool one to three times during 12 to 15 months. Compared with the control group, intervention patients had an 87% higher overall therapeutic intervention rate (19.6 vs. 10.5 therapeutic interventions per patient per 12 months; P=.023).
On average, intervention patients had CVD risk discussion sooner than control patients (90% vs. 50% at first outpatient visit). Ninety-four to 100% of exit survey responses indicated that the tool made it easier for patients to discuss CVD risk with their providers.
The researchers observed no between-group differences in HbA1c, BP or lipid levels, possibly due to the short follow-up period and limited exposure to the intervention, according to Roach.
“Future research should focus on the effectiveness of the intervention in nonresearch settings,” Roach said.
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- Dr. Roach is a consultant to Sanofi. The research was supported by a grant from the Robert Wood Johnson Finding Answers: Disparities Research for Change program.