User-Friendly Technology

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Mobile systems, applications, and social media channels transform diabetes care

When it comes to diabetes care, three basic tenants remain true: diet, medication, and exercise are the foundation of care management. But, how patients and providers manage and track those factors is beginning to change.

Increasingly, patients and healthcare providers are turning to technology - whether it's using a mobile health application to track a patient's status or outcomes, increasing communication between provider and patient through a web portal, or simply finding an online community to connect with others - to facilitate the often-complex efforts necessary to manage the disease.

Some new e-Health tools are being developed to help patients find ways to better self -manage the disease, while other tools focus on bringing the provider and patient together in convenient, cost-effective, and personalized ways.

As e-Health continues to gain momentum, pharmacists can play a crucial role in assisting patients with care management and helping direct patients toward reliable, successful, and user- friendly technology options.

Going mobile

Many diabetes management applications and systems are relying on a piece of technology that most Americans already have: a mobile phone or wireless device. Smartphone applications, web-based systems, or programs that incorporate text messages or emails are often easy and accessible for patients to use and can promote better self -management, engagement, and adherence to treatment plans.

According to a recent report from the Pew Internet & American Life Project, if s estimated that 88% of American adults now own a cell phone and 46% of adults in this country own some type of smartphone. This is an increase from just 1 year earlier, when the Pew Research Center reported that 35% of adult Americans were smartphone owners.

One company catering to America's growing reliance on mobile technology is WellDoc, a healthcare behavioral science company that has created a mobile diabetes intervention system. The system, which serves patients with type 2 diabetes, includes a patient coaching application that can be used with a mobile phone or the internet to provide patients with educational, behavioral, or motivational messages tailored to each user.

The coaching application delivers real-time feedback in response to blood sugar information medications, food, or carbohydrates that they enter into the application" says Malinda Peeples, vice president of clinical advocacy for WellDoc.

For example, if a user enters and confirms a low blood sugar number into the system, he may get a message showing him pictures of 1 5 or 30 g of carbohydrates, depending on his blood sugar range, and will be prompted again in 1 5 minutes to re-test his level.

The system, which has been cleared by FDA, to provide real-time, automated clinical feedback, also looks at clinical algorithms and can make recommendations for classes of drug therapy.

"We're not going to drill down to the actual dose, but we can say it's time to move from metformin, consider insulin, or consider the next category of drug," Peeples says.

The system also includes a clinical-decision support tool that summarizes the patient's status, standards of care, medication profile, and behavioral characteristics for a physician before an office visit. Unlike some mobile applications that are direct to consumer, the system is prescription-based, which Peeples believes fosters the patient-provider relationship and keeps patients engaged and committed to their own care.

Peeples says the potential impact the system could make on care management was demonstrated in a recent clinical trial. During the randomized control trial, researchers found that patients treated with the mobile diabetes intervention system plus their usual care lowered their AIc levels by 1.9% compared to a decrease of 0. …