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Texts to diabetic patients between clinic visits suggestive of benefits to care

Writer: Aaron NeinsteinAaron Neinstein

New study published by Harry Fischer and colleagues in Denver shows increased participation in care by diabetes patients who received text message reminders between visits.  It looks like there was a big increase in the number of patients who provided glucose readings among the group receiving text messages.  Most importantly, the patients reported that they felt “more accountable.”  Accountability and patient empowerment are the trends that will continue to be more and more important and essential.

Abstract below:

Objectives: To assess the feasibility of engaging adults with diabetes in self management behaviors between clinic visits by using cell phone text messaging to provide blood sugar measurement prompts and appointment reminders.

Study Design: Quasi-experimental pilot among adult diabetic patients with cell phones who receive regular care at a federally qualified community health center in Denver, Colorado, which serves a population that is predominantly either uninsured (41%) or on Medicaid or Medicare (56%).

Methods: Patients (N = 47) received text message prompts over a 3-month period. Blood sugar readings were requested 3 times per week (Monday, Wednesday, and Friday). Reminders were sent 7, 3, and 1 day(s) before each scheduled appointment. Acknowledgments were returned for all patient-sent messages. Focus groups were conducted in English and Spanish with selected patients (n = 8).

Results: Patients of all ages were active participants. Correctly formatted responses were received for 67.3% of 1585 prompts. More than three-fourths (79%) of the cohort responded to more than 50% of their prompts. The appointment analysis was underpowered to detect significant changes in attendance. Participants reported increased social support, feelings that the program “made them accountable,” and increased awareness of health information. Two-thirds (66%) of patients provided glucose readings when prompted during the study, compared with 12% at 2 preceding clinic visits.

Conclusions: For certain patients, cell phone–based text messaging may enhance chronic disease management support and patient-provider communications beyond the clinic setting.

(Am J Manag Care. 2012;18(2):e42-e47)

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Dr. Aaron Neinstein is the Chief Medical Officer at Notable, the leading intelligent automation company for healthcare. In this role, he employs his care delivery expertise to strengthen Notable's product strategy and roadmap, ensure high-value customer outcomes, and foster healthcare community engagement on the value of AI and automation for patients and care teams.

 

Prior to joining Notable, Dr. Neinstein spent over a decade as a physician executives in digital health and informatics, most recently as Vice President of Digital Health at UCSF Health. He is an Associate Professor in the UCSF Division of Endocrinology, with a clinical practice focused on diabetes care.

© 2020 by Aaron Neinstein MD

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