Type 2 Diabetes Patients Benefit from the COMODITY12 mHealth System: Results of a Randomised Trial

Abstract

Patient acceptance is one of the major barriers toward widespread use of mHealth systems. The aim of this study was to assess system operability and whole trial feasibility, including patients' experience with their use of COMMODITY12 mHealth system under. Secondary study aims included assessment of several metabolic parameters as well as patient adherence to the treatment. This was a prospective parallel-arm randomized controlled trial in outpatients diagnosed with DM2, being treated in the primary care settings in Lodz region, Poland, with 6 weeks period of follow-up. Patients opinions were collected with 7-item questionnaire, assessing different aspects of system use, as well as EuroQol-5D-5 L questionnaire, assessing health-related quality of life. Sixty patients (female, 24, male, 36, mean age +/- SD 59.5 +/- 6.8) completed study. All four layers of the COMMODITY12 system proved to work smooth under real-life conditions, without major problems. All dimensions of experience with system use were assessed well, with maximum values for clearness of instructions, and ease of use (4.80, and 4.63, respectively). Health related quality of life, as assessed with cumulative utility measure, improved significantly in COMMODITY12 system users (P < 0.05). mHealth system modestly improved glycaemic and blood pressure control, assuring high level of patient adherence with overall adherence reaching 92.9 %. Study proved that the COMODITY12 system is well accepted by type 2 diabetes patients taking part in clinical trial, leading to several clinical benefits, and improved quality of life. Nevertheless, before future commercialisation of the system, several minor problems identified during the study need to be addressed.

Effectiveness of Internet-Based Interventions on Glycemic Control in Patients With Type 2 Diabetes: Meta-Analysis of Randomized Controlled Trials (Preprint)

“…In studies that provided automated feedbacks [18,27,30,37], heterogeneity was reduced to 0.0% and difference between groups was -0.50% (95% CI [-0.72, -0.28], P < .001). In unclear group [8,12,16,19,29,33,36], difference in HbA1c outcomes was not significant as P = .61 > .05. Overall test for heterogeneity between subgroups had a p value of 0.001, indicating statistically significant difference between groups ( figure 3C).…”

“…In the group of x ≤ 3 months [11,21,23,27,33,34,36], heterogeneity across studies was 28.5% and the pooled WMD was -0.45% (95% CI [-0.62, -0.28], P < .001).…”

“…However, moderate heterogeneity of 59.8% was also observed across studies in this subgroup. In the group of mobile only interventions [14,18,24,27,33,36], difference in HbA1c between intervention and control group decreased, with a pooled WMD of -0.23% (95% CI [-0.40, -0.06], P = .009) and heterogeneity of 27.0%. In combined mobile and website group [8,26,30,31,37], no heterogeneity was observed and the pooled effect was -0.46% (95% CI [-0.68, -0.24], P < .001).…”

“…Of the 28 studies included, 9 were conducted in the United States [11,12,19,20,22,25,28,30,31], 7 in the Republic of Korea [7,8,21,23,26,27,37], 2 in Poland [29,36] and Italy [16,35] respectively and 1 in China [34], Japan [33], Finland [18], Turkey [10], Canada [9], Spain [24], Norway [14] and England [32] each. Included studies were published between 2004 and 2016 and the intervention duration ranged from 6 weeks to 5 years.…”

“…7 studies used web-based interventions solely [7,9,10,12,21,29,34], 6 used mobile technology [14,18,24,27,33,36] and 5 used the combination of both [8,26,30,31,37]. 10 studies utilized other forms of new media, including portable digital assistant, tablet computer and data transmission equipment only [11,16,19,20,22,23,25,28,32,35].…”