None listed
Conditions
Brief summary
This study is trialing a digitally enabled model of care to improve glycaemic outcomes in people with type 2 diabetes. The digital tools will enable remote monitoring of diabetes related measures, provide contextual feedback through SMS, easier communication with healthcare professionals and earlier identification of individuals that need enhanced care. It is hypothesized that digital tools for remote monitoring that provide contextual feedback to patients and smart monitoring by healthcare professionals will improve self-management leading to improved glycaemic profile and efficient diabetes care. We will use the REMODeL primarily to: A1: examine glycaemic outcomes in people with type 2 diabetes (T2DM) at 6 months. Assess the impact of REMODeL model of T2DM care pathway on: A2: glycaemic control at 12 months and blood pressure and lipids A3: diabetes distress, patient self-management A4: did-not-attend rates and earlier discharge to primary care. A5: attendance rates at diabetes specialist clinic outpatients, emergency department and hospital admissions A6: healthcare delivery cost and the cost-effectiveness of this model of care
Interventions
Participant will be given access to the new model of care.
REMODeL is an innovative model of care that provides self-management support outside of the traditional in-person clinic visits for people with T2DM through advances in digital technology (MDMS). This will be administered by the tertiary clinic at the Princess Alexandra Hospital and the participants will be contacted based on dashboard review by the diabetes nurse educators. Ad hoc clinic appointments will be scheduled based on need.
Participant will be given access to the new model of care. REMODeL is an innovative model of care that provides self-management support outside of the traditional in-person clinic visits for people with T2DM through advances in digital technology (MDMS). This will be administered by the tertiary clinic at the Princess Alexandra Hospital and the participants will be contacted based on dashboard review by the diabetes nurse educators. Ad hoc clinic appointments will be scheduled based on need. After 12 months of being enrolled in the model of care, patients will be discharged from the REMODeL system. At this point, patients will return to receiving the standard care from the outpatient clinic. The technology will include the following components: (1) a Bluetooth-enabled glucose meter which transmits blood glucose level data wirelessly to a smartphone app, a web-based clinician dashboard that the HCP can review daily; (2) automated alerts for health care professional via the dashboard to identify patients with hyperglycaemia, hypoglycaemia or those not achieving components of their annual cycle of care; this dashboard will be reviewed by diabetes educators from Monday to Friday excluding public holidays. The diabetes educator will respond to dashboard alerts as determined by a pre-existing algorithm, for eg., if there are dangerously out of range measures and will communicate with the participant either via message or a phone call after consulting with the doctor if required. (3) motivational and educational SMS text messages providing contextual feedback to the people with diabetes (PWD), triggered based on their glycaemic profile 2 times per week. An additional lifestyle message will be sent once per week. Additional dangerous out of range blood glucose measures will be trigger an SMS the following day. The participants can respond to text messages and will be actioned during business hours. (4) PWD access to educational materials available on the internet like Diabetes Australia will be used.
Sponsors
The University of Queensland
Study design
Allocation
Non-randomised trial
Intervention model
Other
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Type 2 diabetes duration for at least 2 years prior to consent, • A glycated haemoglobin (HbA1c) result greater than equal to 8% within the 6 weeks prior to consenting to participate in the study, • Referred to Diabetes Clinic for management of type 2 diabetes (includes inpatient referral), • Consent to access their Queensland Health data related to diabetes care.
Exclusion criteria
• Do not have a compatible smartphone, • Pregnant or planning to be pregnant, due to the difference in diabetes management in this group • Unable to communicate in English • Bariatric surgery within the last 12 months, due to impact on clinical markers which may skew trial results, • Severe mental illness, • Cognitive impairment, • Unstable medical condition as determined by the treating clinician, • Use a continuous glucose monitor, • Enrol in other clinical trials. • Previous enrolment into REMODel randomised control trial or implementation project
Outcome results
None listed