Outcomes of a feasibility trial using an innovative mobile health programme to assist in insulin dose adjustment

BMJ Health Care Inform. 2019 Oct;26(1):e100068. doi: 10.1136/bmjhci-2019-100068.

Abstract

Objective: Intensification of diabetes therapy with insulin is often delayed for people with suboptimal glycaemic control. This paper reports on the feasibility of using an innovative mobile health (mHealth) programme to assist a diabetes insulin dose adjustment (IDA) service.

Methods: Twenty adults with diabetes referred to a tertiary hospital IDA service were recruited. They were provided with a cloud-based mobile remote monitoring system-the mobile diabetes management system (MDMS). The credentialled diabetes educator (CDE) recorded the time taken to perform IDA utilising the MDMS versus the conventional method-which is a weekly adjustment of insulin doses by a CDE through telephone contact based on three or more daily blood glucose readings. Participants and staff completed a feedback questionnaire.

Results: The CDE spent 55% less time performing IDA using MDMS than using the conventional method. The participants were satisfied with MDMS use and the CDEs reported improved efficiency.

Conclusion: Incorporating a mHealth programme for an IDA service has the potential to improve service delivery efficiencies while simultaneously improving the patient experience.

Keywords: health care; medical informatics; patient care.

MeSH terms

  • Adult
  • Aged
  • Blood Glucose Self-Monitoring / methods*
  • Diabetes Mellitus / drug therapy*
  • Feasibility Studies
  • Female
  • Health Educators / organization & administration
  • Health Educators / statistics & numerical data
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / therapeutic use
  • Insulin / administration & dosage*
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Self Care
  • Smartphone*
  • Telemedicine / methods*
  • Tertiary Care Centers
  • Young Adult

Substances

  • Hypoglycemic Agents
  • Insulin