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mHealth Messages Improve Diabetes Chronic Disease Management

Healthcare providers can improve chronic disease management of Type 2 diabetes through brief automated mHealth messages that encourage behavioral changes.

By Jacqueline LaPointe

- A recent study by the Journal of Medical Internet Research found that brief automated messages can significantly improve chronic disease management for Type 2 diabetes patients, especially in regards to glycemic control.

mHealth messages can improve chronic disease management

After employing automated messaging techniques that aimed to boost physical activity and healthy eating, patients experienced an estimated 0.53% decrease in hBA1c, although there was no significant change in body mass index with this strategy.

Control of hBa1c is important because for every percentage point decrease over 10 years, there are reductions in diabetes-related deaths by 21 percent, myocardial infarctions by 14 percent, and microvascular complications by 37 percent.

Researchers aimed to uncover how messaging patients can help chronic disease management for 387 million individuals around the world who are living with Type 2 diabetes. Experts anticipate the population to increase to 592 million people by 2035.

The study looked at the impact of brief messages that were delivered to mobile devices to help Type 2 diabetes patients sustain healthier behavioral changes. Messages are inexpensive and wide-reaching compared to clinician-patient interventions and they can provide fast personalized messages to patients, explained the report.

“This type of intervention could address non-adherence to lifestyle recommendations by providing frequent reminders, motivational support and prompts to action, as well as timely access and feedback to relevant health information, while making patient-provider communication much easier,” wrote the authors of the study.

The researchers examined 15 trials that sent either unidirectional or bidirectional messages to patients with Type 2 diabetes. Unidirectional messages were sent from providers or researchers to the participant while bidirectional messages involved a two-way interaction with patients and researchers.

Participants who received bidirectional messages used self-monitoring strategies to send health data in real-time to researchers. Researchers would then send back personalized feedback.

Despite significant improvements to clinical outcomes, researchers revealed that interventions that involved two-way communication with healthcare experts were just as effective as unidirectional messages.

“Interventions based on the use of one-way messages produced a very similar effect to those based on two-way messages, which can be more tailored and usually require more complex technology, and are more resource intensive,” explained the report.

More importantly, healthcare providers should focus on characteristics of the messaging system, such as convenience, ease of use, mobility, and if the message can be read more than once, the study pointed out.

Researchers found that brief automated messages were generally an acceptable and successful tool for patients who are self-managing Type 2 diabetes. Three trials even reported high acceptability and satisfaction with the strategy.

However, in one trial that used web-based messages, participants reported low acceptability because the interface was not user-friendly and some individuals were inexperienced with mobile web use.

Another trial used video-messages to relay health information and reported that 47 percent of participants in the intervention group did not even view the videos, or, they stopped watching the videos after two months.

Additionally, the study stated that messaging interventions were more successful in low to moderate income countries.

“Our results suggested that the interventions were more effective in LMIC [low- and middle-income countries] than in HIC [high-income countries],” reported the study. “Increasing evidence suggests that mHealth interventions are a useful tool to address health care system constraints in developing countries, namely limited health care workforce, limited financial resources, high burden of disease, and difficulties in providing healthcare to hard-to-reach populations.”

Many healthcare providers are seeking methods for improving chronic disease management, especially for Type 2 diabetes. The condition has become a major physical and economic burden on the global healthcare industry.

As this study showed, providers may have answers in messaging systems that encourage long-lasting lifestyle changes. Secure messaging allows healthcare providers to inexpensively manage the care of patients inside and outside of the facility, which could lead to less spending and improved patient outcomes.


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