Mobile Diabetes Tools Improve Glycemic Control

Patients with type 2 diabetes (T2D) who use mobile devices to access diabetes management portals were more adherent and had improved glycated hemoglobin A1c (HbA1c) levels, according to a new study.

Researchers at Emory University (Atlanta, GA, USA), Kaiser Permanente Northern California (Oakland, USA), Harvard Medical School (HMS; Boston, MA, USA), and other institutions conducted a retrospective study involving 111,463 Kaiser Permanente patients with diabetes (who also serving as their own controls) in order to examine the effect of adding mobile patient portal access on medication adherence and glycemic levels. Access status was categorized as never used, used from a computer only, used from a mobile device only, or used from both computer and mobile device.

Patients could register online for free access, which allowed them to get general health information, see test results, securely send and receive messages to and from their healthcare providers, make medical appointments, and request prescription refills. The main outcomes and measures were medication adherence, as measured by monthly percentage of days covered (PDC); and glycemic levels, a measured by changes in HbA1c levels. The results showed that the number of patients using the portal from both a computer and mobile device increased over time from 34.42% in April 2015 to 61.71% in December 2017.

Among those with no prior portal access, adding computer-only portal access was associated with an increase in PDC of 1.16% and a change of −6% in HbA1c level. Adding both mobile and computer portal access was associated with an increase in PDC of 1.67% and a change of −13% in HbA1c level. Among those patients with baseline HbA1c level higher than 8%, changing from no portal access to both computer and mobile access was associated with an increase in PDC of 5.09% and a change of −19% in HbA1c level. The study was published on February 19, 2020, in JAMA Network Open.

“This is an example of how the healthcare system, by offering patients access to their own information and the ability to manage their healthcare online, can improve their health. Offering this in a mobile-friendly way can give even more patients the ability to engage with their healthcare,” said senior author Mary Reed, PhD, of the Kaiser Permanente Division of Research. “Patients can use technology to better manage their own care, their medications, and their diabetes. It literally puts the access to these tools in the patient's own pocket wherever they go.”

Related Links:
Emory University
Kaiser Permanente Northern California
Harvard Medical School