mHealth Interventions for Disadvantaged and Vulnerable People with Type 2 Diabetes.
Adult
Cell Phone
Developing Countries
Diabetes Mellitus, Type 2
/ economics
Ethnicity
Humans
Internet
Minority Groups
Patient Acceptance of Health Care
/ statistics & numerical data
Poverty
Rural Population
Self-Management
Telemedicine
/ economics
Vulnerable Populations
/ statistics & numerical data
Disadvantaged
Disparities
HbA1c
Lifestyle intervention
Mobile
Technology interventions
Type 2 diabetes
Journal
Current diabetes reports
ISSN: 1539-0829
Titre abrégé: Curr Diab Rep
Pays: United States
ID NLM: 101093791
Informations de publication
Date de publication:
25 11 2019
25 11 2019
Historique:
entrez:
27
11
2019
pubmed:
27
11
2019
medline:
28
5
2020
Statut:
epublish
Résumé
Mobile- and Internet-delivered (collectively, digital) interventions are widely used by persons with diabetes (PWD) to assist with self-management and improve/maintain glycemic control (hemoglobin A1c [A1c]). However, evidence concerning the acceptance and benefits of such interventions among disadvantaged/vulnerable PWD is still quite limited. We reviewed studies published from 2011-April 2019 evaluating the impact of diabetes self-management interventions delivered via mobile device and/or Internet on glycemic control of disadvantaged/vulnerable adults with type 2 diabetes (T2D). Included studies reported ≥ 50% of the sample having a low socioeconomic status and/or being a racial/ethnic minority, or living in a rural setting or low-/middle-income country (LMIC). We identified 21 studies evaluating a digital intervention among disadvantaged/vulnerable PWD. Although many digital interventions found within-group A1c improvements (16 of 21 studies), only seven of the seventeen studies with a control group found between-group differences in A1c. Three studies found reductions in emergency room (ER) visits and hospitalizations. We synthesize this information, and provide recommendations for increasing access, and improving the design and usability of such interventions. We also discuss the role of human support in digital delivery, issues related to study design, reporting, economic value, and available research in LMICs. There is evidence suggesting that digital interventions can improve diabetes control, healthcare utilization, and healthcare costs. More research is needed to substantiate these early findings, and many issues remain in order to optimize the impact of digital interventions on the health outcomes of disadvantaged/vulnerable persons with diabetes.
Sections du résumé
BACKGROUND
Mobile- and Internet-delivered (collectively, digital) interventions are widely used by persons with diabetes (PWD) to assist with self-management and improve/maintain glycemic control (hemoglobin A1c [A1c]). However, evidence concerning the acceptance and benefits of such interventions among disadvantaged/vulnerable PWD is still quite limited.
PURPOSE OF REVIEW
We reviewed studies published from 2011-April 2019 evaluating the impact of diabetes self-management interventions delivered via mobile device and/or Internet on glycemic control of disadvantaged/vulnerable adults with type 2 diabetes (T2D). Included studies reported ≥ 50% of the sample having a low socioeconomic status and/or being a racial/ethnic minority, or living in a rural setting or low-/middle-income country (LMIC). We identified 21 studies evaluating a digital intervention among disadvantaged/vulnerable PWD.
RECENT FINDINGS
Although many digital interventions found within-group A1c improvements (16 of 21 studies), only seven of the seventeen studies with a control group found between-group differences in A1c. Three studies found reductions in emergency room (ER) visits and hospitalizations. We synthesize this information, and provide recommendations for increasing access, and improving the design and usability of such interventions. We also discuss the role of human support in digital delivery, issues related to study design, reporting, economic value, and available research in LMICs. There is evidence suggesting that digital interventions can improve diabetes control, healthcare utilization, and healthcare costs. More research is needed to substantiate these early findings, and many issues remain in order to optimize the impact of digital interventions on the health outcomes of disadvantaged/vulnerable persons with diabetes.
Identifiants
pubmed: 31768662
doi: 10.1007/s11892-019-1280-9
pii: 10.1007/s11892-019-1280-9
pmc: PMC7232776
mid: NIHMS1575235
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
148Subventions
Organisme : NIDDK NIH HHS
ID : P30 DK092949
Pays : United States
Références
Am J Prev Med. 2016 Nov;51(5):816-824
pubmed: 27745681
Diabetes Care. 2014;37(3):e53-4
pubmed: 24558085
Telemed J E Health. 2014 Jan;20(1):75-82
pubmed: 24205809
J Health Care Poor Underserved. 2005 Nov;16(4):734-46
pubmed: 16311495
J Soc Distress Homeless. 2017;26(1):73-77
pubmed: 31097900
J Am Med Inform Assoc. 2018 Aug 1;25(8):1080-1088
pubmed: 29788380
Int J Med Inform. 2011 Jun;80(6):389-405
pubmed: 21481632
J Med Internet Res. 2016 Nov 25;18(11):e310
pubmed: 27888169
Diabet Med. 2010 Jun;27(6):613-23
pubmed: 20546277
Public Health Rep. 2003 Jul-Aug;118(4):293-302
pubmed: 12815076
Med Care. 2002 Jan;40(1 Suppl):I140-51
pubmed: 11789627
J Med Internet Res. 2015 May 07;17(5):e112
pubmed: 25953147
PLoS Med. 2015 Jul 14;12(7):e1001852
pubmed: 26172977
N Engl J Med. 2011 Oct 20;365(16):1509-19
pubmed: 22010917
Ann Pharmacother. 2011 Feb;45(2):169-78
pubmed: 21304026
J Am Med Inform Assoc. 2017 Sep 1;24(5):1014-1023
pubmed: 28340030
J Cardiovasc Transl Res. 2014 Nov;7(8):677-91
pubmed: 25209729
Lancet. 1998 Sep 12;352(9131):837-53
pubmed: 9742976
J Diabetes Sci Technol. 2015 Apr 30;9(6):1321-6
pubmed: 25934517
Diabetes Care. 2008 Feb;31(2):240-6
pubmed: 17977939
J Ambul Care Manage. 2014 Apr-Jun;37(2):127-37
pubmed: 24594561
J Diabetes Sci Technol. 2012 Mar 01;6(2):310-9
pubmed: 22538140
Health Promot Pract. 2014 Nov;15(2 Suppl):51S-61S
pubmed: 25359249
Diabetes Educ. 2009 Mar-Apr;35(2):233-6, 238-41, 244-5
pubmed: 19240246
Health Educ Behav. 2008 Oct;35(5):664-82
pubmed: 17513690
J Appl Gerontol. 2014 Jun;33(4):416-36
pubmed: 24781964
Circulation. 2015 Nov 24;132(21):2012-27
pubmed: 26596977
Diabetes Technol Ther. 2017 Aug;19(8):476-482
pubmed: 28581821
J Intern Med. 2018 Feb;283(2):212-213
pubmed: 28881402
Patient Educ Couns. 2013 Jan;90(1):125-32
pubmed: 23063349
Diabetes Educ. 2014 Nov-Dec;40(6):806-19
pubmed: 25278512
Diabetes Care. 2012 Oct;35(10):2005-11
pubmed: 22815295
Health Educ Res. 2012 Aug;27(4):755-65
pubmed: 21926065
Am J Prev Med. 2019 Jul;57(1):111-116
pubmed: 31130463
Diabetes Care. 2015 Aug;38(8):e112-3
pubmed: 26207059
Fam Pract. 2010 Jun;27 Suppl 1:i6-16
pubmed: 19276176
Soc Sci Med. 2015 Aug;139:90-9
pubmed: 26164364
J Am Med Inform Assoc. 2017 Sep 1;24(5):1024-1035
pubmed: 28379397
Diabetes Technol Ther. 2011 Mar;13(3):335-41
pubmed: 21299402
J Med Internet Res. 2015 Feb 24;17(2):e52
pubmed: 25803266
J Med Internet Res. 2015 Oct 05;17(10):e224
pubmed: 26441467
Psychother Psychosom. 2009;78(5):275-84
pubmed: 19602916
J Med Internet Res. 2016 Nov 18;18(11):e307
pubmed: 27864165
J Gen Intern Med. 2007 Jan;22(1):115-20
pubmed: 17351850
Ann Intern Med. 2014 Nov 18;161(10 Suppl):S13-22
pubmed: 25402398
Diabetes Care. 2017 Oct;40(10):1349-1355
pubmed: 28600309
Diabetes Educ. 2004 Jul-Aug;30(4):665-75
pubmed: 15669782
Med Care. 2003 Nov;41(11):1221-32
pubmed: 14583685
Diabetes Educ. 2011 Sep-Oct;37(5):680-8
pubmed: 21918206
Perspect Health Inf Manag. 2011 Jan 01;8:1b
pubmed: 21307985
Diabetes Technol Ther. 2012 Jun;14(6):492-6
pubmed: 22524591
Ann Emerg Med. 2014 Jun;63(6):745-54.e6
pubmed: 24225332
Diabetes Care. 2006 Sep;29(9):2130-6
pubmed: 16936167
Am J Prev Med. 2009 Dec;37(6 Suppl 1):S262-9
pubmed: 19896028
J Health Commun. 2012;17 Suppl 1:67-72
pubmed: 22548601
JAMA Intern Med. 2013 Feb 25;173(4):315-7
pubmed: 23303245
J Gen Intern Med. 2008 Dec;23(12):1992-9
pubmed: 18855075
J Diabetes Complications. 2014 Mar-Apr;28(2):243-51
pubmed: 24332469
Health Aff (Millwood). 2014 Feb;33(2):265-72
pubmed: 24493770
JAMA Netw Open. 2019 Jun 5;2(6):e196386
pubmed: 31251377
Annu Rev Public Health. 2015 Mar 18;36:483-505
pubmed: 25581147
Diabetes Spectr. 2015 May;28(2):83-91
pubmed: 25987806
J Gen Intern Med. 2011 Feb;26(2):170-6
pubmed: 20878497
Diabetes Technol Ther. 2014 Jul;16(7):454-9
pubmed: 24502284
Arch Intern Med. 2009 Oct 26;169(19):1788-94
pubmed: 19858437
Diabetes Care. 2010 Jun;33(6):1200-5
pubmed: 20200302
J Med Internet Res. 2014 Jun 06;16(6):e149
pubmed: 24907918
J Clin Endocrinol Metab. 2012 Sep;97(9):E1579-639
pubmed: 22730516
Diabetes Care. 2006 Jan;29(1):131-2
pubmed: 16373908
J Natl Med Assoc. 2013 Spring;105(1):51-8
pubmed: 23862296
J Diabetes Metab Disord. 2015 Jun 03;14:49
pubmed: 26075190
Diabetes Care. 2015 Apr;38(4):561-7
pubmed: 25633661
J Med Internet Res. 2014 Aug 08;16(8):e187
pubmed: 25135688
Epidemiol Rev. 2010;32:56-69
pubmed: 20354039
Diabetes Care. 2013 Sep;36(9):2697-705
pubmed: 23637355
Diabetes Educ. 2016 Feb;42(1):34-71
pubmed: 26637240
Diabetes Care. 2014 Jun;37(6):1759-66
pubmed: 24855158
J Telemed Telecare. 2011;17(7):365-70
pubmed: 21933896
Diabetes Educ. 2013 May-Jun;39(3):365-75
pubmed: 23610181
Curr Diab Rep. 2018 Oct 18;18(12):130
pubmed: 30338403
Acta Diabetol. 2016 Apr;53(2):189-98
pubmed: 25936739
Rural Remote Health. 2011;11(4):1798
pubmed: 21995854
Prim Care Diabetes. 2014 Dec;8(4):275-85
pubmed: 24793589
Diabetes Care. 2005 May;28(5):1045-50
pubmed: 15855565