Chronic Care Management/Patient Relationship Management Proof of Concept

Denver Health and Hospital Authority47 enrolled

Overview

This proof of concept study proposes to evaluate the feasibility of a communications-technology-based chronic care and patient relationship management program to improve diabetes self management among adult diabetic patients in an urban safety net population by providing between-visit reminders and chronic disease support through cell phone text messaging. The investigators hypothesize that diabetic patients enrolled in the program will be less likely to miss scheduled appointments and will have greater perceived self-efficacy and improved patient satisfaction concerning chronic disease management. No-show rates among patients enrolled in the program are expected to be lower than among patients receiving standard care.

Study Type

INTERVENTIONAL

Allocation

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

Conditions

Diabetes Mellitus

Interventions

Patients will be contacted through SMS text messaging under the following circumstances: * 7 days, 2 days, and 1 day before scheduled appointments. Messages will contain the date, time, and location where the appointment is scheduled. Patients will be prompted to respond with 'YES' if they are able to keep their appointment, and 'NO' if they need to reschedule. An acknowledgement of receipt will be sent in response to all patient-initiated messages. * 3 days per week to request that patients respond with fasting blood sugar measurements. An acknowledgement of receipt will be sent in response to all patient-initiated messages.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 76 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients with diabetes * receive care at a primary care clinic in the DH system * between 18 and 76 years of age * primary language of English or Spanish * ownership of a qualifying cell phone (SMS text capable) * ownership of a glucometer. Exclusion Criteria: * life expectancy less than six months, * do not have or cannot use a phone or glucometer * do not want to participate

Outcomes

Primary Outcomes

Patient Engagement

Patient engagement was assessed by patient text message response rates and average response times. Response rates were calculated as a percentage from the number of patient-initiated text messages sent in response to a system-generated request for information (the numerator) divided by the total number of system-generated requests for information (the denominator). Average response times were calculated from system-recorded time stamps for outbound requests sent and inbound patient-initiated responses received.

Time frame: 3 months

Secondary Outcomes

Appointment Attendance

As measured by no-show rates for appointments at all clinics during the study period, compared between intervention and control groups

Time frame: 3 months

Perceived Self-efficacy

As measured by comparison of patient responses to validated assessment instrument administered at baseline and post-intervention

Time frame: 3 months

Glycemic Control

Measured by patients' self-reported fasting blood glucose levels during the intervention period and compared to previous laboratory data in the medical record.

Time frame: 3 months

Chronic Care Management/Patient Relationship Management Proof of Concept

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes