Successful Delivery of Diabetes Self-Care Education and Follow-Up through eHealth Media

Abstract

BackgroundeHealth systems are being rapidly diffused and used by health organizations, healthcare providers and patients for diabetes educational purposes because of perceived cost savings, convenience and access from remote locations. ObjectiveTo compare the use of 3 education systems that varied media (face-to-face vs. electronic), communication (e.g. synchronous and asynchronous) and information processing functionality (e.g. Internet searching, view laboratory blood test results) for education of newly diagnosed patients with type 2 diabetes mellitus. Design/MethodsIn a randomized controlled trial, changes in glycated hemoglobin (A1C), self-efficacy and diabetes knowledge were compared between 3 models of education and communication support in newly diagnosed patients with type 2 diabetes: controls (face-to-face education, synchronous and asynchronous communication), Web Static (electronic education and virtual appointments using asynchronous communication) and Web Interactive (electronic education and virtual appointments using both synchronous and asynchronous communication). ResultsIn an intent-to-treat analysis, all 3 groups had similar improvement in diabetes knowledge, self-efficacy and diabetes self-care activities. Independent of which group subjects were randomized to, findings were significant when examining correlation between website usage and outcomes: a higher total use was associated with a higher diabetes knowledge score (r=0.265, p=0.029), a higher total diabetes self-efficacy by final study visit (r=0.317, p=0.008) and a lower A1C by final study visit (r=−0.271, p=0.026) by the last visit. ConclusionsInitial diabetes education can be delivered successfully through electronic media. Higher adoption of electronic media is associated with improved clinical outcomes.