Diabetes education program ‘nudges’ patients toward better health
BOSTON — A digital health coaching program employing weekly telephone, text messaging and email contacts helped adults with type 2 diabetes lose weight, reduce HbA1c and maintain those benefits for a year, according to study results presented here.
In a prospective study, Dhiren Patel, PharmD, CDE, BC-ADM, BCACP, clinical director for Pack Health, which developed the program, and colleagues enrolled 756 adults with type 2 diabetes for 12 months between June 2014 and November 2017. Participants were matched with a nonclinical health adviser who provided personalized strategies and motivational messages to help them achieve individualized goals. The advisers did not adjust medications, but answered participants’ questions about their health and helped coordinate education and communication between patients and their providers.
“We’re not telling people to go up on their insulin or go down on a specific medication,” Patel said. “We’re working on a lot of the other determinants of health, behavior modification, behavior changes, to produce these results.”
Advisers conferred with participants to define larger goals and break down the steps toward achieving them. Participants received a 10- to 15-minute phone call, three text messages and an email message each week for 3 months.
“We have an ‘omnichannel’ approach,” Patel told Endocrine Today. “Text messages we define as ‘nudges.’ Whatever that module or curriculum might be for that week, whatever goals they’ve set, it would be related to that.”
At 3 months, participants had lost a mean of 4.9 lb and reduced HbA1c to a mean 7.4% from baseline 8.4%, with similar results at 12 months. Researchers also observed a 19% increase in the number of participants who adhered to annual foot exams and a 17% increase in those receiving eye exams.
“We’re taking a more holistic approach in coaching these folks,” Patel said. “A patient who has diabetes could also have high blood pressure as well as mental health issues, and we’re not saying we can only help you with your diabetes. [For example,] we realize that depression is the bigger issue and we need to make sure we get help for them with that first before we can even do anything with diabetes. We take the approach that if you do what’s right for the patient in the long term, all of the comorbid conditions will improve, including the one that you’re looking at, because no one just has diabetes.” – by Jill Rollet
Patel D, et al. LB1209. Presented at: AACE Annual Scientific and Clinical Congress; May 16-20, 2018; Boston.
Disclosure:The study was funded by Pack Health. Patel reports he is clinical director for Pack Health.