Diabetes texting program gets a boost

By Bernie Monegain
09:11 AM

The Center for Connected Health has received a research grant from the McKesson Foundation's Mobilizing for Health initiative to integrate a text-messaging program into an existing program at Massachusetts General Hospital to help diabetes patients better manage their condition.

The goal of Mobilizing for Health is to improve health outcomes among under-served patients with chronic diseases using mobile health (mHealth) technologies that have proven successful. The grant program aims to provide a clearer understanding of how mobile phones can be used to improve health outcomes, and study findings could indirectly impact millions of patients around the world, say McKesson executives.

"We are honored to have been selected by the McKesson Foundation as a 2011 grant recipient," said Joseph C. Kvedar, MD, director of the center, which is part of Partners HealthCare. "Our experience with text messaging programs in underserved patient populations is demonstrating great potential for providing low-cost, accessible educational messaging to patients, and we applaud the foundation for their support of innovative, technology-driven solutions for chronic disease management."

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"The Mobilizing for Health research grants allow us to increase the evidence base for mobile health interventions," said Carrie Varoquiers, president of the McKesson Foundation. "The use of mobile phones in healthcare seems very promising, especially in low-income populations with chronic diseases, but we need to better understand what works before these interventions can be scaled."

The Center's randomized, controlled clinical trial will integrate a text messaging program into an existing Diabetes Self-Management and Education (DSME) program at three of Massachusetts General Hospital's community health centers representing medically underserved and low-income populations in the Boston area.

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The goal of the study is to assess the effect of personalized text messages on clinical outcomes and physical activity in patients with Type 2 Diabetes, many of whom are obese or have low levels of activity. Results will be measured by change in HbA1c (the clinical measure for blood sugar control), as well as patients' engagement, usability and satisfaction with the program. The study will also use pedometers to measure physical activity, to better target messages to engage patients in behavior change to increase their activity levels. 

Text messages will include coaching to improve activity levels, and reminder, educational and motivational messages to help patients meet their diabetes self-management goals. Offered in English or Spanish they, will be personalized for each patient based on their initial stage of behavior change, or willingness to change behavior.

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"While DSME programs have shown to reduce complications, improve diabetes self-management and quality of life, diabetic patients are likely to discontinue recommended behavior changes without ongoing support," noted Kamal Jethwani, MD, lead research scientist, Center for Connected Health, and principal investigator for the study. "By adding two key connected health cornerstones – objective data collection and targeted personalized feedback – we believe that patients will adopt new behaviors sooner and maintain healthy behavior for longer. And, because text messaging is a low-cost, widely available technology, we hope to improve the overall quality of diabetes management for a larger pool of patients."

In total, the McKesson Foundation Awards totaled $1.4 millon. The foundation did not release the amount of the individual grants.

The other recipients are:

Baystate Medical Center
Purpose: Develop and field test an integrated mHealth solution to improve daily adherence to medications and blood glucose and blood pressure monitoring among older Type 2 diabetes patients.
Albert Einstein Medical Center
Purpose: Test the hypothesis that providing doctors and nurses with regular feedback from their diabetic patients using integrated mobile phone technology will result in improved blood sugar control.
Medic Mobile
Purpose: Develop and pilot an SMS-based appointment validation tool to automate the process of confirming and rescheduling appointments for low-income diabetic patients.
Scripps Whittier Diabetes Institute
Purpose: Test the effectiveness of using a mobile health application in improving the management of diabetes in a recently diagnosed diabetic Latino population.
Vanderbilt University Medical Center
Purpose: Design and testing of a mobile assessment and intervention system for low-income adults with Type 2 diabetes.