A 3-Month Randomized Controlled Pilot Trial of a Patient-Centered, Computer-Based Self-Monitoring System for the Care of Type 2 Diabetes Mellitus and Hypertension

Abstract

This study was performed to evaluate the effects of a patient-centered, tablet computer-based self-monitoring system for chronic disease care. A 3-month randomized controlled pilot trial was conducted to compare the use of a computer-based self-monitoring system in disease self-care (intervention group; n = 33) with a conventional self-monitoring method (control group; n = 30) in patients with type 2 diabetes mellitus and/or hypertension. The system was equipped with a 2-in-1 blood glucose and blood pressure monitor, a reminder feature, and video-based educational materials for the care of the two chronic diseases. The control patients were given only the 2-in-1 monitor for self-monitoring. The outcomes reported here included the glycated hemoglobin (HbA1c) level, fasting blood glucose level, systolic blood pressure, diastolic blood pressure, chronic disease knowledge, and frequency of self-monitoring. The data were collected at baseline and at 1-, 2-, and 3-month follow-up visits. The patients in the intervention group had a significant decrease in mean systolic blood pressure from baseline to 1 month (p < 0.001) and from baseline to 3 months (p = 0.043) compared with the control group. Significant improvements in the mean diastolic blood pressure were seen in the intervention group compared with the control group after 1 month (p < 0.001) and after 2 months (p = 0.028), but the change was not significant after 3 months. No significant differences were observed between the groups in the fasting blood glucose level, the HbA1c level, or chronic disease knowledge. The frequency of self-monitoring of blood glucose level and blood pressure was similar in both groups. The performances of the tablet computer-assisted and conventional disease self-monitoring appear to be useful to support/maintain blood pressure and diabetes control. The beneficial effects of the use of electronic self-care resources and support provided via mobile technologies require further confirmation in longer-term, larger trials.

Mobile Apps to Support the Self-Management of Hypertension: Systematic Review of Effectiveness, Usability, and User Satisfaction (Preprint)

“…Most studies (n=11) were conducted in the US [24][25][26][27][28][29][30][31][32] and Canada [33,34], while seven were carried out in European countries, including France [35], Sweden [36][37][38], Spain [39,40] and Italy [41]. The remaining three studies were conducted in China [42,43] and South Korea [44. Nine studies were randomised controlled trials (RCTs) [24,25,27,28,30,[33][34][35]42], ten were nonrandomised studies [26,29,31,32,37,[39][40][41]43,44], and two were qualitative studies [36,38].…”

“…Participants' average age ranged from 42.4 years [27] to 69.5 [42] years. The population groups of the studies included individuals with hypertension [24][25][26][27][28][29][30]32,[36][37][38][39][41][42][43][44], metabolic syndrome risk factors [34], and obstructive sleep apnoea with high cardiovascular risk [35], as well as overweight individuals [31]. Of the 21 included studies, 5 reported to have used behavioural theories, such as selfdetermination theory [24,26,27], motivational interviewing [30] and theory of planned behaviour [43] to underpin and guide the intervention methods and/or the development of the technology.…”

“…Nine studies aimed to enhance selfmanagement without involving clinicians to monitor patients remotely [29,33,[35][36][37][38][42][43][44]. The other 11 studies mainly involved clinicians or other HCPs remotely monitoring patient data and health status [24][25][26][27][28][30][31][32][39][40][41], whilst the remaining study involved the researcher remotely monitoring patient data and alerting physicians if needed [34,36].…”

“…The other 11 studies mainly involved clinicians or other HCPs remotely monitoring patient data and health status [24][25][26][27][28][30][31][32][39][40][41], whilst the remaining study involved the researcher remotely monitoring patient data and alerting physicians if needed [34,36]. In these 11 studies involving HCPs, the HCPs provided feedback, including a medication plan or adjustments [24][25][26][27]39,41], regular online coaching consultation [31] instructions [28,30] or communication with patients [40,42]. …”

“…The control group in the controlled studies had usual care. In some studies this was combined with recording of [34] and the BP measurements [42] in a logbook or with education provided by a nurse [28].…”