The peer-reviewed study, published in the Journal of the American Medical Informatics Association, was conducted by Palo Alto Foundation Medical Group serving northern California. About 400 patients with uncontrolled diabetes participated in the trial, funded through the Agency for Healthcare Research and Quality.
Half of the patients were in an “intervention group” (INT) and given a wireless glucometer and a smartphone loaded with a personalized care plan for a year, along with access to a diabetes care manager and educational messages. The other patients were in a “usual care” (UC) control group with access to regular clinic care. The trial paid for a data plan for those given a smartphone.
After six months, patients in the intervention group with smartphones and a wireless home glucometer had significantly reduced A1C levels compared with patients receiving usual care, but the differences were not significantly different after 12 months. However, intervention group patients had significantly better control of their LDL cholesterol at 12 months, and initiated many more online messages to providers during their time in the study.
“Regarding medication management, there was a significant difference in the two groups in the number of medication orders to initiate a new medication or change an existing medication (1,312 INT vs. 1,158 UC), and the number of insulin orders,” according to the study.
Intensification of diabetes treatment, such as a new treatment or increase in insulin dose, also was higher in the INT group. “For patients already receiving insulin, the INT group significantly increased the doses of insulin (227 vs. 90).” Yet, there were not significant differences in the number of total physician visits between the two groups.