A Randomised Control Trial to Explore the Impact and Efficacy of the Healum Collaborative Care Planning Software and App on Condition Management in the Type 2 Diabetes Mellitus Population in NHS Primary Care
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Abstract
Introduction
Effective and scalable solutions to support management of Type 2 Diabetes (T2D) at a distance are a priority for health systems worldwide. The use of personalised care planning has been shown to be effective at improving the health outcomes and the experience of care amongst people with T2D and other long-term health conditions. Here we describe a specific example of such an intervention.
Methods
The sample comprised 197 participants with T2D randomised to either the active intervention group with digital health planning (App + usual care), with 115 participants, or the control group (usual care), with 82 participants. We analysed data in relation to changes in body mass index (BMI) and glycated haemoglobin (HbA1c) over a 6-month follow-up period. We also analysed responses to questionnaires sent out and held interviews with participants that were in the active treatment group and therefore had a care plan created and access to an app.
Results
The active treatment group had significant reductions in HbA1c (p < 0.01) and BMI (p < 0.037) vs the control group (no significant change). The average percentage change in HbA1c for the treatment group over 6 months was − 7.4% (± SE 1.4%), compared with 1.8% (± SE 2.1%) for the control group. The average percentage change in BMI for the treatment group was − 0.7% (± SE 0.4%) and it was − 0.2% (± SE 0.5%) for the control group. A higher percentage of the active treatment group reduced their HbA1c and BMI than the control group. For HbA1c, 72.4% of the active treatment group reduced their HbA1c, compared to 41.5% of the control group. For BMI, 52.7% of the active treatment group experienced a reduction, compared to 42.9% for the control group. Self-measured quality of life (QoL) improved for patients in the active treatment group, shown by an increase in their pre-trial to post-trial EQ-5D-5L rating by an average of 0.0464 (± SE 0.0625), compared to a decrease of 0.0086 (± SE 0.0530) for the control group. The average EQ VAS score also increased pre- to post-trial for the active treatment group, on average by 8.2%, whereas it decreased by an average of − 2.8% for the control group.
Conclusion
These findings point to how the provision of personalised plans of care, support and education linked to a mobile app, can result in HbA1c and BMI reduction for many individuals with T2D. The use of a patient management app as well as a personalised care plan also led to an improvement in patient self-rated QoL and engagement.
Key Summary Points
- The number of people with type 2 diabetes (T2D) is steadily increasing, thus there is a need for them to self-manage more effectively to reduce the complications of this disorder and reduce the pressure within primary care of treating these patients.
- This study set out to evaluate whether a personalised care planning software and patient-facing mobile app could improve health outcomes amongst people with T2D.
- The provision of personalised plans of care, support and education linked to a mobile app, resulted in HbA1c and BMI reductions over a 6-month period for individuals with T2D.
- The provision of personalised plans of care, support and education linked to a mobile app, resulted in an improvement in quality of life and patient engagement for individuals with T2D.
