This study tests a mobile health tool for collecting and sharing patient-reported outcomes as a part of everyday clinical practice, and ultimately, whether the tool improves care and outcomes for individuals with type 2 diabetes.
Study Overview
Problem: Much of clinical practice for type 2 diabetes focuses on addressing the impacts of the disease on a patient’s physical health. Inclusion of the patients' perspective of their health and functional status and understanding what outcomes they most desire is less common, but necessary for improving care.
Main Objective: To evaluate the usability and efficacy of a mobile health tool that incorporates patients’ perspective into the clinical management of type 2 diabetes.
Approach: This study will implement an innovative mobile health tool for managing diabetes care (i-Matter). The tool uses text-messaging to collect and share patient-reported outcomes and sends patients feedback and motivational messages based on the information they share. The platform also creates dynamic data visualizations of the patient’s data, which is integrated into the electronic health record, and can be reviewed by their primary care clinicians during and between visits.
In the first phase of the study, the research team will use qualitative methods to evaluate the usability, performance, and workflow integration of the i-Matter tool in meeting the needs of clinicians and patients. In the second phase, the research team will randomize 282 participants to receive either usual care for diabetes or care supplemented with the i-Matter tool. Outcomes include mean reduction in blood sugar levels, changes in patient adherence to lifestyle and medication recommendations, and patient-provider communication.
Results: While the study is ongoing, the research team has published results from an analysis on longitudinal user engagement data. Analyses revealed three distinct subgroups of patients used the i-Matter tool: a low-engaged group, a moderately engaged group, and a highly engaged group, with the latter being the largest.1 Future analyses will determine whether these engagement patterns impact patients’ behavioral and clinical health outcomes. If so, engagement patterns can be used to identify patients in need of additional support.
Current and future publications from this grant will be posted here.
Primary Care Relevance
This project has the potential to harness the use of technology, such as the mobile phone and electronic health record, to support the delivery of high-quality patient-centered care for patients with type 2 diabetes in primary care settings.
AHRQ Primary Care Priority Area
Notes
1. Mandal, S., Belli, H. M., Cruz, J., Mann, D., & Schoenthaler, A. (2022). Analyzing user engagement within a patient-reported outcomes texting tool for diabetes management: engagement phenotype study. JMIR Diabetes 7(4), e41140. https://doi.org/10.2196/41140.
