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Published on 27.10.15 in Vol 1, No 1 (2015): October

Preprints (earlier versions) of this paper are available at http://preprints.jmir.org/preprint/4637, first published May 12, 2015.

This paper is in the following e-collection/theme issue:

    Abstract

    Evaluating Acceptability of Cellular Glucose Meter Use in a Diabetes Care Management Program: A Qualitative Study

    1Division of Health Informatics and Implementation Science, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States

    2Center for Healthcare Organization and Implementation Research (CHOIR), eHealth Quality Enhancement Research Initiative (QUERI), National eHealth QUERI Coordinating Center, Bedford, MA, United States

    3Diabetes Center of Excellence, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States

    Corresponding Author:

    Daniel J Amante, MPH

    Division of Health Informatics and Implementation Science

    Department of Quantitative Health Sciences

    University of Massachusetts Medical School

    368 Plantation Street

    Worcester, MA, 01605

    United States

    Phone: 1 508 856 8480

    Fax:1 508 856 8993

    Email:


    ABSTRACT

    Background: Diabetes is difficult to manage and many patients require additional support to control their disease. Increasingly, connected health technologies, such as secure patient portals, are being used in diabetes care management programs to provide such support. Uploading self-monitored blood glucose (SMBG) recordings to patient portals is an increasingly common strategy to support improved monitoring. Recently introduced cellular glucose meters can be used to automate the upload process immediately after testing. Automatic uploading eliminates the need for patients to connect meters to a computer and enables support teams to monitor uploads in real-time and in turn, provide in-the-moment support as needed. Despite their potential to improve diabetes management, the use of cellular glucose meters is not without challenges. Although designed for simplicity and seamless use, meters sometimes require a degree of technological skill that certain patients may not possess. Patients may also struggle to understand how to best utilize functionality to help manage their disease. When perceived ease of use or usefulness is low, utilization of the technology may result in unanticipated consequences. For this reason, patient acceptability must be evaluated before cellular glucose meters can be implemented more broadly.

    Objective: To evaluate patient acceptability of cellular glucose meter use in a diabetes care management program.

    Methods: Patients with Type 1 and Type 2 diabetes received cellular glucose meters and were enrolled in a care management program. Certified Diabetes Educators (CDEs) monitored uploaded SMBG recordings. The CDEs provided structured support and coaching to participants and interacted with their medical providers as necessary. After 1 month of the program, focus groups and semi-structured phone interviews were conducted with the participants. Audio recordings of each were transcribed verbatim and the resulting transcripts were thematically coded. An a priori code list, based on the Technology Acceptance Model, was used to guide the analysis and further codes were added to represent other themes from the transcripts.

    Results: Participants with Type 1 (n=6) or Type 2 (n=10) diabetes reported that the cellular glucose meter was both easy to use and useful. The meter’s most favorable features were the automatic and seamless uploading of SMBG recordings, SMBG tracking and sharing tools, and tips provided through the meter. The support provided by the CDEs through the management program was also identified as being helpful. Identified areas of improvement included providing training on the meter and program, improved consistency and efficiency of the meter’s functional performance, and additional meter functionality.

    Conclusions: All participants reported a positive overall experience using the meter as part of the care management program. Future work should focus on long-term patient acceptability and efficacy of using cellular glucose meters in diabetes management programs and the subsequent effects on clinical service utilization and provider workflow.

    iProc 2015;1(1):e2

    doi:10.2196/iproc.4637

    KEYWORDS


    (This is a conference paper presented at the Connected Health Symposium, Boston, 2015, which was not edited and is only lightly peer-reviewed).

    Multimedia Appendix 1

    Extended Abstract.

    PDF File (Adobe PDF File), 216KB

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    Edited by G Eysenbach, T Hale; submitted 12.05.15; peer-reviewed by T Irizarry, S Beidas, C Berridge; accepted 20.07.15; published 27.10.15

    ©Daniel J. Amante, Timothy P. Hogan, Thomas M. English, Ruby W. Fairchild, David M. Harlan, Michael J. Thompson. Originally published in JMIR Mhealth and Uhealth (http://www.iproc.org), 27.10.2015.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.