mHealth for Diabetes Adherence Support

Research project

Description

PROJECT SUMMARY Many African-Americans and Latinos with diabetes do not achieve recommended diabetes goalsplacing them at high risk for complications. Team-based models of care can help in reaching goals of therapy.Additionally, mobile health (mHealth) technologies can further improve outcomes among those more difficult toreach. This study will evaluate the impact of a team-based, mHealth intervention designed to improvemedication adherence, healthy eating, and physical activity behaviors. We will compare this mHealthapproach with usual care. Clinical pharmacists and health coaches (HC) will deliver our proposed team-based intervention.mHealth delivery includes mobile phone text messaging, secure videoconferencing, and HC home visits.Pharmacists will focus on medication reconciliation and adherence. Health coaches will help identifypsychosocial and environmental challenges to adherence in a culturally-sensitive manner. Together, they canassist in goal-setting, problem-solving, negotiation of competing priorities, and provide social supportleveraging mHealth technologies. Preliminary data from our research group supports the role of health coaches partnering with clinic-based pharmacists in improving diabetes outcomes in minorities. In the proposed mHealth intervention, patient-pharmacist videoconferencing will eliminate the need for in-person visits with a pharmacist, which is impracticalfor many low-income patients. In addition, our pilot work suggests that text messaging is a preferable means ofcommunication and may facilitate more frequent contact with patients. We propose a randomized, controlled trial to evaluate the effectiveness of an mHealth diabetesadherence support intervention delivered by clinical pharmacists and health coaches. We will randomize 220patients through UI Health to either: (1) mHealth diabetes adherence support through clinical pharmacists andhealth coaches; or (2) usual care. After one year, patients completing the mHealth intervention will bemonitored for an additional year while the usual care group receives the mHealth approach. Outcomes includemedication adherence, hemoglobin A1c, blood pressure, and LDL-cholesterol levels. The specific aims include:(1) evaluate the effectiveness of an mHealth diabetes adherence support intervention delivered by clinicalpharmacists and health coaches to African-American and Latino adults with uncontrolled type 2 diabetes; (2)evaluate the maintenance of improved diabetes behaviors as well as clinical outcomes one year aftercompleting the intervention; (3) evaluate the cost and cost-effectiveness of mHealth diabetes adherencesupport compared to usual care; and (4) evaluate the reach, adoption, and implementation of mHealthdiabetes adherence support based on the RE-AIM framework.
StatusActive
Effective start/end date7/15/166/30/21

Funding

  • National Institutes of Health: $702,361.00

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Telemedicine
Pharmacists
Health
Text Messaging
Videoconferencing
Biomedical Technology
Hispanic Americans
African Americans
Medication Reconciliation
House Calls
Cell Phones
Medication Adherence
Negotiating
LDL Cholesterol
Cost-Benefit Analysis
Hemoglobins
Motor Activity
Randomized Controlled Trials
Eating
Blood Pressure