Mobile Health Intervention in Patients with Type 2 Diabetes: A Randomized Clinical Trial

02/02/2024

Gerber BS, Biggers A, Tilton JJ, et al. Mobile Health Intervention in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open 2023;6(9):e2333629. doi:10.1001/jamanetworkopen.2023.33629

This randomized clinical trial addressed whether mobile health (mHealth) tools could help improve blood glucose levels in African American and Latinx individuals with type 2 diabetes. Continued research has shown that African American and Latinx populations with type 2 diabetes have higher hemoglobin A1c (HbA1c) levels than non-Latinx white populations. Here the authors explored whether mHealth tools facilitating pharmacist and health coaching activities could bridge these existing racial and ethnic disparities. Two hundred and twenty-one African American and Latinx adults participated in this two-year trial. Participants were randomized to receive the intervention in year one or year two (waitlist control). During the intervention pharmacists liaised with participants’ primary healthcare providers to determine therapeutic goals, discussed patient experiences with health coaches, monitored medications, reviewed participants’ logs of glucose and blood pressure, and provided one-on-one education to patients via the telehealth platform VSee. Participant meetings ranged from 30 minutes to one hour, occurring every 2-3 months. From the initial 221 enrolled in the trial, 187 completed the intervention and follow-up visit. During the first twelve months, participants’ HbA1c levels in the intervention group showed improvement compared to the waitlist group (p = 0.005). The waitlist group also showed the benefits of the intervention, displaying a change in HbA1c when receiving the intervention compared to the first 12 months (p = 0.002). Despite no longer receiving the intervention in the ladder 12 months, participants who received the intervention in the first 12 months continued to maintain lower HbA1c compared to baseline through 24 months. This study provides support for the utility of a virtual integrative team for managing type 2 diabetes in African American and Latinx populations.