WellDocTM Mobile Diabetes Management RCT: Change in Clinical and Behavioral Outcomes, Patient and Physician Satisfaction
Charlene C. Quinn, RN, Ph.D.,1 Suzanne Sysko Clough, M.D.2, James M. Minor, Ph.D., Ph.D.,2 Dan Lender, M.D.,3 Maria C. Okafor, MCG.,1 Ann Gruber-Baldini, Ph.D.,1
Objective: The primary study aim was to assess the impact on A1c of a cell phone based diabetes management software system used in conjunction with web based data analytics and therapy optimization tools. Secondary aims included examining health care provider (HCP) adherence to recommended prescribing guidelines and assessing HCPs adoption of the technology.
Research Design and Methods: 30 patients with type 2 diabetes were recruited from three community physician practices for a 3 month study and evenly randomized to an intervention or control group. The intervention group received cell phone based software designed by endocrinologists and certified diabetes educators (WellDoc Communications, Inc, "WellDoc"). The software provided real time feedback on patients' blood glucose (BG) levels, displayed patients' medication regimens, incorporated hypo and hyperglycemia treatment algorithms, and requested additional data needed to evaluate diabetes management. Patient data was captured and transferred to WellDoc's» servers. The data was analyzed by WellDoc's» statistical algorithms and diabetes team. WellDoc» sent computer generated logbooks (with suggested treatment plans based on WellDoc's» analysis) to intervention patients' HCPs.
Results: The average decrease in A1c for intervention patients was 2.03%, compared to 0.68% (p<.02, one tailed) for control patients. 84% of intervention patients had their medications titrated or changed by their HCP compared to 23% of control patients (p=0.002). Intervention patients' HCPs reported that WellDoc's» analysis facilitated treatment decisions, provided organized data, and reduced logbook review time.
Conclusions: Adults with type 2 diabetes using WellDoc's software achieved statistically significant improvements in A1c. HCP and patient satisfaction with the system was clinically and statistically significant.
1 Division of Gerontology, Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD
2 WellDoc Communications, Inc. Baltimore, MD
3 Joslin Diabetes Center, University of Maryland Medical System and School of Medicine, University of Maryland, Baltimore, MD