Disclosures: Oikonomidi reports no relevant financial disclosures.
January 28, 2021
3 min read
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Most adults with diabetes open to remote digital monitoring

Disclosures: Oikonomidi reports no relevant financial disclosures.
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Nearly two-thirds of adults with diabetes said they would be willing to adopt remote digital monitoring if the method was just as or more effective than their current monitoring, according to study data.

“These findings show that remote digital monitoring is promising,” Theodora Oikonomidi, MSc, a PhD candidate at the University of Paris, told Healio. “Not only are many patients ready to adopt [remote digital monitoring] as their usual care, but there are modifiable factors that we can improve through better monitoring systems design to facilitate adoption.”

Oikonomidi is a PhD candidate at the University of Paris.

Oikonomidi and colleagues conducted a vignette-based survey in a cohort of Anglophone and Francophone adults from 30 countries with type 1 and type 2 diabetes between February and July 2019. Participants were recruited from social media, patient forums, diabetes-related websites, email and in-person to achieve a diverse sample.

Each participant responded to two questions on three randomly selected vignettes related to remote digital monitoring for diabetes. One vignette selected one of three monitoring tools, the second selected one of six duration and feedback loop scenarios, and the third had data handled by either a public sector or private organization. There were 36 total vignette scenarios that could be generated. The survey asked participants how effective remote monitoring would be in reducing the frequency of hypoglycemic episodes and eye complications over their current method of monitoring. Responses were given on a five-point scale, ranging from “much less effective” to “much more effective.” The study’s findings were published in JAMA Network Open.

A total of 1,010 adults completed at least one vignette (57% women; median age, 51 years). There were 2,860 vignette assessments completed during the study period. Overall, 65% of participants reported they would adopt remote digital monitoring if was just as or somewhat more effective than their current monitoring. In 34% of assessments, participants said they would adopt remote digital monitoring if it was less effective or just as effective than their current monitoring in reducing hypoglycemic episodes, 31% if it was somewhat more effective, and 36% if it was much more effective. The vignette with the lowest minimum required effectiveness was permanent glucose and physical activity monitoring with real-time, artificial intelligence-generated treatment and lifestyle feedback and public-sector data handling.

For prevention of eye complications, the results were similar, with 32% of participants saying they would adopt remote digital monitoring if it were just as or less effective than current monitoring, 32% saying they would adopt if it was somewhat more effective, and 35% if it was much more effective.

Monitoring intrusiveness; the addition of occasional food monitoring to glucose- and physical activity-monitoring; and feedback by a care professional other than the participant’s regular physician were three factors associated with minimum required effectiveness for reducing hypoglycemic episodes and eye complications. Other factors associated with minimum required effectiveness for reducing hypoglycemic episodes included permanent monitoring with real-time feedback from the patient’s regular physician; the addition of regular food monitoring to glucose- and physical activity-monitoring; and permanent monitoring with real-time, AI-generated treatment feedback.

“We found that the perceived intrusiveness of remote digital monitoring impacts patients’ willingness to adopt it, so it’s important that we look into ways to design less intrusive monitoring systems,” Oikonomidi said. “This requires research done in collaboration with patients, to understand their needs and ideas for better remote digital monitoring design.”

The views of remote digital monitoring varied for at least half of the vignettes in all participant subgroups, showing how the view of monitoring varies on an individual basis.

“Physicians who prescribe remote digital monitoring systems could benefit from following the principles of shared decision-making,” Oikonomidi said. “Patients’ willingness to adopt remote digital monitoring depends on how they view its specific modalities, and how they can fit them into their daily lives. These preferences vary among individuals, so physicians and their patients should work together to select the best type of remote digital monitoring for each patient.”

For more information:

Theodora Oikonomidi, MSc, can be reached at theodora.oikonomidi@inserm.fr.