Following a visit to the emergency department, patients with diabetes are more likely to adhere to their medications and control their illness when they receive daily automated text messages about the disease, according to a study published in the journal Annals of Emergency Medicine.
Increasingly, low-income inner-city patients in the US with diabetes use emergency departments (EDs) for acute and chronic care. Researcher looked at whether a low-cost, unidirectional, text message–based mobile health intervention (TExT-MED) could improves clinical outcomes, increase healthy behaviors, and decreases Emergency Department visits.
They conducted an randomized controlled trial of 128 adult patients with poorly controlled diabetes in an urban, public ED. The TExT-MED group received 2 daily text messages for 6 months in English or Spanish. The primary outcome was change in Hb A1C level. Secondary outcomes included changes in medication adherence, self-efficacy, performance of self-care tasks, quality of life, diabetes-specific knowledge, ED use, and patient satisfaction.
Hb A1C level decreased by 1.05% in the TExT-MED group compared with 0.60% in the controls at 6 months. Secondary outcomes favored the TExT-MED group, with the most sizable change observed in self-reported medication adherence. Effects were larger among Spanish speakers for both medication adherence and Hb A1C in the TExT-MED group. The proportion of patients who used emergency services trended lower in the TExT-MED group. Overall, 93.6% of respondents enjoyed TExT-MED and 100% would recommend it to family/friends.
The researchers concluded that although the TExT-MED program did not result in a statistically significant improvement in Hb A1C, trends toward improvement in outcomes, including quality of life, were observed, the most pronounced being improved medication adherence. TExT-MED also decreased ED use. These findings were magnified in the Spanish-speaking subgroup. Technologies such as TExT-MED represent highly scalable, low-cost, and widely accessible solutions for safety-net ED populations.
S Arora, , A Peters, E Burner et al. Trial to Examine Text Message–Based mHealth in Emergency Department Patients With Diabetes (TExT-MED): A Randomized Controlled Trial. Annals of Emergency Medicine.