It’s the conundrum of every clinician who cares for patients with diabetes: How do you keep them engaged and motivated in their self-care during the gaps between office visits? The findings of a study from an established multimedia company may point to one solution.
Launched in 2004 as the only national television show exclusively about diabetes, “dLife” is also an interactive website/online community, a radio show, a mobile app, and a resource for diabetes educators. Now, the company has sponsored a study that demonstrated measurable benefit from a tailored, 24-hour online intervention for people with type 2 diabetes.
Commissioned by dLife with an unrestricted grant to the Geisinger Health System, the study — officially called Technology in Diabetes Engagement and Self-Care (TIDES) — enrolled 166 adult type 2 diabetes patients identified via electronic medical records at three of Geisinger’s primary care sites. They were randomized to usual care or that plus unlimited use of a tailored online portal containing weekly diabetes self-care topics, Q&A with experts, quizzes, recipes, diet assistance, videos of segments from the television show, and social networking forum. Motivational messages were displayed throughout.
Participants received weekly email newsletters highlighting the site’s features. The site was available 24/7, so patients could use it as often as they wanted on their own schedule.
Over 6 months, 76% of the 117 in the intervention group were “engaged” in the site, opening the emails/links, and/or taking the quizzes. At 6 months, those randomized to the site improved in 9 of 11 variables on the Diabetes Knowledge Questionnaire, compared with no change in the controls. Change in the score was significantly correlated with the degree of site usage, according to Geisinger’s Dr. Margaret Rukstalis, who presented the findings at the recent meeting of the American Association of Diabetes Educators.
Although there was no overall difference at 6 months in median change from baseline in hemoglobin A1c between the intervention group and controls, the difference was significant among those who experienced a drop in A1c, by 0.8 percentage points compared with just 0.3 for the controls.
Dr. Rukstalis said that she believes the intervention filled a gap in clinical care. “Given many rural persons with diabetes are often medically underserved with limited access and ability to attend traditional lifestyle interventions, TIDES demonstrates how multimedia engages persons with diabetes via email and web in their own lives.”
The founder/CEO of dLife, Howard Steinberg, told me that the company plans to introduce the intervention to health plans, provider groups and employers, and that it will be available in various forms over time. Meanwhile, elements of TIDES are available right now at dLife.com.
According to Mr. Steinberg, “We plan on studying the impact TIDES will have on improving practice efficiency, as it is low cost and requires little or no time from them. Doctors can feel confident that dLife is evidence based, effective and engaging.”
-Miriam E. Tucker (@MiriamETucker on Twitter)