Funding to Explore How Technology Can Boost Adherence in Diabetes Patients

Researchers from the University of Illinois at Chicago (UIC) have received a $4 million grant to study how mobile technology can improve treatment adherence in African American and Hispanic diabetes patients.

The American Diabetes Association estimates that nearly 30 million Americans are living with diabetes, costing the country $322 billion per year. Furthermore, many African Americans and Latinos are at high risk of developing complications from the disease, including amputations, end-stage kidney disease, and severe retinopathy that can result in blindness, because they don’t properly manage their disease and health.

With the 5-year, $4 million grant, researchers will evaluate whether mobile technology, such as videoconferencing and text messaging, can help patients improve their medication adherence, become more physically active, and eat a healthier diet.

The study will include 220 patients from the University of Illinois Hospital & Health Sciences System, who will receive extra support from clinical pharmacists and health coaches. The health coaches will try to identify psychosocial and environmental challenges to adherence, as well as culturally-informed ways to overcome them, while pharmacists will focus on medication compliance.

Researchers hope that it will help patients set goals, negotiate competing priorities, and problem-solve.

“One of the problems in this patient population is their blood glucose decreases, but they can’t keep it there,” said UIC researcher Lisa Sharp. “Life happens to them. They may lose loved ones, or experience financial stress. There are all sorts of challenges for people with limited resources living in inner cities.”

Additionally, other issues may include socially isolated patients who don’t have anyone to help them inject their insulin, or they may have limited eyesight that makes it difficult for them to be adherent to their treatment regimen. The health workers will step in to help patients identify people involved in their daily lives who can help them manage their diabetes.

“Family dynamics are often complicated,” said UIC researcher Ben Gerber. “Patients may be uncomfortable in reaching out to family members, or people from their church or neighborhood. We’re trying to find out what the best way is to communicate with them and identify resources in the community that can assist. Family members are thankful that the community health workers are helping their loved ones.”

In the upcoming study, the health coaches will initially visit the patients in their homes to learn about their condition and how they manage it. Although there will be follow-up home visits, the number will vary, according to researchers.

Additionally, the health coaches may accompany patients to their visits to the pharmacy and physician’s office.

Text messages will remind patients to take their medications, while also providing support and encouragement. Furthermore, health coaches will use tablet computers to videoconference from their patients’ homes with pharmacists.

“Videoconferencing will reduce the need for in-person visits with a pharmacist, as many low-income patients cannot physically make it to their appointments,” Gerber said. “Also, our prior work suggests that text messaging is a desirable means of communication and may facilitate more frequent contact with patients.”

Researchers hope that the upcoming study will provide further insight into diabetes management in African American and Latino patients.

“We’re trying to learn who this model works for, and then we can use resources that make the most sense that will help them,” Sharp said. “We’re trying to empower the patient to pay more attention to their health.”