A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support

Abstract

Technology-enabled diabetes self-management solutions significantly improve A1c. The most effective interventions incorporated all the components of a technology-enabled self-management feedback loop that connected people with diabetes and their health care team using 2-way communication, analyzed patient-generated health data, tailored education, and individualized feedback. The evidence from this systematic review indicates that organizations, policy makers and payers should consider integrating these solutions in the design of diabetes self-management education and support services for population health and value-based care models. With the widespread adoption of mobile phones, digital health solutions that incorporate evidence-based, behaviorally designed interventions can improve the reach and access to diabetes self-management education and ongoing support.

2017 National Standards for Diabetes Self-Management Education and Support

“…Moving beyond static lecture methodology, incorporating meaningful discussions to address individual needs, and using interactive teaching styles are required. Incorporating PGHD, especially blood glucose and/or continuous glucose monitoring data, into decision making individualizes self-management and empowers participants to fully engage in personal problem solving to change behavior and improve outcomes (16,(142)(143)(144). There is strong evidence that incorporating text messaging into DSMES interventions improves engagement and outcomes (25,(145)(146)(147).…”

“…There is strong evidence that incorporating text messaging into DSMES interventions improves engagement and outcomes (25,(145)(146)(147). Use of digital technology (cloud-based, telehealth, data management platforms, apps, and social media) enhances the ability to employ a technology-enabled selfmanagement feedback loop with four key elements: two-way communication, analysis of PGHD, customized education, and individualized feedback to provide realtime engagement in self-management, as well as to enable and empower participants (16).…”

“…Creative solutions incorporating technology to increase reach and engagement must be examined (73,74). Telehealth, electronic health records (EHR), mobile applications, and cognitive computing will proactively identify and track participants while offering endless opportunities for individualized and contextualized DSMES (16,(75)(76)(77)(78).…”

“…Thus, the focus of the Standards should include helping the person with diabetes develop problem-solving skills and attain ongoing decision-making support necessary to self-manage diabetes. In addition, encouraging e-health tools (24) and online peer support (25) will allow for the implementation of a complete feedback loop essential to facilitate ongoing self-management (16,26). Diabetes also carries with it a risk for burnout, which, as it develops, can lead to poorer health outcomes (27).…”

“…and technology-enabled models of care (15,16). By following the Standards, DSMES should be incorporated in new and emerging models of care, including virtual visits, Accountable Care Organizations, Patient-Centered Medical Homes, population health programs, and value-based payment models (17)(18)(19)(20).…”