Affiliations 

  • 1 Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  • 2 Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan
  • 3 Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
  • 4 Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
  • 5 Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  • 6 Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 7 Faculty of Public Health, Mahidol University, Bangkok, Thailand
JMIR Mhealth Uhealth, 2020 06 02;8(6):e14024.
PMID: 32484448 DOI: 10.2196/14024

Abstract

BACKGROUND: Many technology-assisted innovations have been used to manage disease. However, most of these innovations are not broadly used by older adults due to their cost. Additionally, disease management through technology-assisted innovations has not been compared with other interventions.

OBJECTIVE: In this study, we tested the employment of a free and widely used social and communication app to help older adults with diabetes manage their distress and glycemic control. We also compared the effectiveness of the app with 2 other methods, namely telephone and conventional health education, and determined which subgroup experiences the most effects within each intervention.

METHODS: Adults aged ≥50 years with type 2 diabetes were recruited from Southern Taiwan (N=231) and were allocated to different 3-month interventions. Informed consent was obtained at the Ministry of Science and Technology and approved by the National Cheng Kung University Hospital Institutional Review Board (No. A-ER-102-425).

RESULTS: Participants in the mobile-based group had significant reductions in hemoglobin A1c compared with the telephone-based and usual care groups (mean changes of -0.4%, 0.1%, and 0.03%, respectively; P=.02). Diabetes-specific distress decreased to a greater extent in the mobile-based group compared to the other 2 groups (mean changes of -5.16, -3.49, and -2.44, respectively, P=.02). Subgroup analyses further revealed that the effects on reducing blood glucose levels in the social and communication app groups were especially evident in patients with lower distress scores, and diabetes-related distress was especially evident in participants who were younger than 60 years or had higher educational levels.

CONCLUSIONS: The findings of this study inform more flexible use of social and communication apps with in-person diabetes education and counselling.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.