Web-based programs help patients with diabetes feel empowered to take care of themselves
Research Activities, January 2010, No. 353
Patients with diabetes who use Web-based case management programs score better on measures of psychosocial self-efficacy and empowerment compared with those without access to these programs. This may help them engage in more effective self-care behaviors such as diet, exercise, and blood-glucose monitoring that can reduce the risk of diabetic complications, note the authors of a pilot study. They looked at the effectiveness of a Web-based disease management program using five different Web sites.
For a period of 12 months, adults with moderately or poorly controlled type 1 diabetes who took daily insulin shots were randomized to one of two interventions. Those in the control group received usual care from their team at the diabetes care center. Patients randomized to the disease management program continued to receive usual care combined with access to a nurse case manager. They also could use four Web sites that allowed them to access their medical record, upload blood-glucose readings, create a daily diary of activities, and generate care-action plans. A fifth Web site provided participants with a variety of educational information.
Nearly two-thirds (65.9 percent) of patients in the intervention group completed at least one blood-glucose reading. The majority of patients (61 percent) also accessed their electronic medical record via the Web from home. The intervention group had significantly higher scores than the control group on the Diabetes Empowerment Scale. This most often translates into better self-care behavior. There was no effect of the Web-based case management on A1c blood levels (a marker of diabetes control) between the two groups.
The researchers point out, however, that less than one-fourth of the intervention group used the Web resources consistently. They call for larger studies to clarify the impact of the intervention on patient outcomes. The study was supported in part by the Agency for Healthcare Research and Quality (HS13853).
See Web-based collaborative care for type 1 diabetes: A pilot randomized trial, by Kelly P. McCarrier, Ph.D., M.P.H., James D. Ralston, M.D., M.P.H., Irl B. Hirsch, M.D., and others, in the 2009 Diabetes Technology & Therapeutics 11(4), pp. 211-217.