mHealth app helps insulin dose adjustment

A mobile health application can be incorporated into an insulin dose adjustment service for people with diabetes – saving time and avoiding data transcription errors in patient care. 

A feasibility study of a mobile diabetes management system (MDMS) in 20 patients at the Princess Alexandra Hospital (PAH) has also shown the patients are quite comfortable and satisfied with the technology. 

Participants in the study were provided with a bluetooth-enabled glucose-meter (Accu-Chek Aviva Connect, Roche Diagnostics) and if necessary, a compatible smartphone. 

Patients were trained face-to-face on the use of the app and the glucose meter. 

Their glycaemic status was automatically uploaded to the dashboard from which educators could then text message patients about adjustments and other advice. 

The study, published in BMJ Health & Care Informatics, compared the average time for these transactions compared to usual care where educators phone the patient for their glucose reading and provide advice. 

It found the mean time for IDA using MDMS was 5.1 minutes compared to 11.3 minutes with conventional approaches. 

“The higher time requirements were more often related to the process involved in making multiple attempts to contact participants,” the study said.

“The IDA service at the PAH has a capacity of accommodating 50 new diabetes patients per week. From the median time taken per IDA contact in this study and using a conservative estimate of 1 contact per patient per week, the total calculated time per week required for IDA using MDMS is 255 min as opposed to 565 min with the conventional IDA service. This equates to a potential CDE time saving of 5.16 hours/week.”

Despite a few technical hitches such as bluetooth connectivity, user experience data showed patients were satisfied with the MDMS and had a high preference for continuing to use the system.

Senior investigator Dr Anthony Russell, from the Centre for Health Services Research at the University of Queensland and the PAH’s Department of Diabetes and Endocrinology, told the limbic any time saved could help to reduce waiting lists.

“You can see more people more efficiently and get them to control quicker and hopefully discharge them back to primary care,” he said. 

He said the MDMS has been incorporated into their clinic and the results of a RCT will be published soon.

“We also have some tele-health seed funding from the Queensland government to actually roll it out more broadly in our clinic and also in regional and remote centres in Toowoomba and Longreach to translate its use into practice.” 

MRFF funding is also being used to look at how to roll the program out into primary care “so we have the whole healthcare team on board” in an integrated care approach.

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