Effects of a Digital Patient Empowerment and Communication Tool on Metabolic Control in People With Type 2 Diabetes : The DeMpower Multicenter Ambispective Study
Orozco-Beltrán, Domingo (Universidad Miguel Hernández de Elche. Departamento de Medicina Clínica)
Morales, Cristobal Jesus (Department of Endocrinology. Hospital Vithas)
Artola, Sara (Centro de Salud José Marvá (Madrid))
Brotons, Carlos (Institut d'Investigació Biomèdica Sant Pau)
Carrascosa, Sara (El Campello Primary Health Care Center)
González, Cintia (Institut d'Investigació Biomèdica Sant Pau)
Baro Pato, Óscar (Galapagar Primary Care Center. RedGDPs Foundation)
Aliaga, Alberto (Department of Endocrinology. Clínica New Technologies in Diabetes and Endocrinology)
Ferreira de Campos, Karine (Medical Affairs Department. MSD Spain)
Villarejo, Maria (Medical Affairs Department. MSD Spain)
Hurtado, Carlos (Medical Affairs Department. MSD Spain)
Álvarez-Ortega, Carolina (Medical Affairs Department. MSD Spain)
Gómez-García, Anton (Medical Affairs Department. MSD Spain)
Cedenilla, Marta (Medical Affairs Department. MSD Spain)
Fernández, Gonzalo (Medical Affairs Department. MSD Spain)

Date:	2022
Abstract:	Background: Diabetes is a major health care problem, reaching epidemic numbers worldwide. Reducing hemoglobin A (HbA) levels to recommended targets is associated with a marked decrease in the risk of type 2 diabetes mellitus (T2DM)-related complications. The implementation of new technologies, particularly telemedicine, may be helpful to facilitate self-care and empower people with T2DM, leading to improved metabolic control of the disease. Objective: This study aimed to analyze the effect of a home digital patient empowerment and communication tool (DeMpower App) on metabolic control in people with inadequately controlled T2DM. Methods: The DeMpower study was multicenter with a retrospective (observational: 52 weeks of follow-up) and prospective (interventional: 52 weeks of follow-up) design that included people with T2DM, aged ≥18 and ≤80 years, with HbA levels ≥7. 5% to ≤9. 5%, receiving treatment with noninsulin antihyperglycemic agents, and able to use a smartphone app. Individuals were randomly assigned (2:1) to the DeMpower app-empowered group or control group. We describe the effect of empowerment on the proportion of patients achieving the study glycemic target, defined as HbA≤7. 5% with a ≥0. 5% reduction in HbA at week 24. Results: Due to the COVID-19 pandemic, the study was stopped prematurely, and 50 patients (33 in the DeMpower app-empowered group and 17 in the control group) were analyzed. There was a trend toward a higher proportion of patients achieving the study glycemic target (46% vs 18%; P=. 07) in the DeMpower app group that was statistically significant when the target was HbA≤7. 5% (64% vs 24%; P=. 02) or HbA≤8% (85% vs 53%; P=. 02). The mean HbA was significantly reduced at week 24 (−0. 81, SD 0. 89 vs −0. 15, SD 1. 03; P=. 03); trends for improvement in other cardiovascular risk factors, medication adherence, and satisfaction were observed. Conclusions: The results suggest that patient empowerment through home digital tools has a potential effect on metabolic control, which might be even more relevant during the COVID-19 pandemic and in a digital health scenario.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Empowerment ; Home digital tool ; Telemedicine ; Type 2 diabetes ; Diabetic ; Home based ; Home care ; Self-management ; Digital tool ; Metabolic ; HbA ; Glycated hemoglobin ; Glycemic control ; Adherence ; Satisfaction ; Observational study ; Health app
Published in:	JMIR Diabetes, Vol. 7 Núm. 4 (january 2022) , p. e40377, ISSN 2371-4379

DOI: 10.2196/40377
PMID: 36190763

13 p, 473.7 KB

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