Accepted for/Published in: JMIR Diabetes
Date Submitted: Mar 10, 2018
Open Peer Review Period: Mar 12, 2018 - May 7, 2018
Date Accepted: Dec 10, 2018
(closed for review but you can still tweet)
Achieving Value-Based Care in Chronic Disease Management: The DiaMonD (diabetes monitoring device) Solution
ABSTRACT
Background:
The World Health Organization (WHO) notes that diabetes, a chronic disease, is a silent epidemic, and by 2020 there will be a 54% rise in the total number of individuals diagnosed with this disease (WHO 2017). These are alarming figures, which have significant repercussions for the quality of life of individuals and their families as well as for the financial stress of healthcare systems globally. Early detection and proactive management of diabetes is essential.
Objective:
The aim of the study was to assess the usability, acceptability and fidelity of Diabetes Monitoring Device (DiaMonD) for patients with gestational diabetes mellitus (GDM). Specifically assessed were: 1) Patient compliance, 2) Patient satisfaction, 3) Level of Glycaemic control achieved, and 4) Health professional satisfaction.
Methods:
Using a design science research perspective, the Diabetes Monitoring Device (DiaMonD) solutions was adapted to the Australian healthcare environment. Once the solution was deemed fit for purpose by the director of the OBGYN clinical institute and on securing all relevant ethics approvals, a two-period two-arm non-blinded cross over clinical trial was conducted for 8 weeks total time with cross over at 4 weeks to establish proof of concept, usability and fidelity. The patient perspective was assessed by using structured questionnaires at four specific stages of the project while the clinician perspective was captured via semi-structured interviews and unstructured questionnaires.
Results:
The ten patients studied reported preferring standard care with the technology solution to standard care alone. Further, all the clinicians involved concurred that the technology solution greatly assisted their ability to provide higher value patient centred care. They also noted that it was extremely helpful for assisting in systematically monitoring glucose levels and any/all changes and trends.
Conclusions:
Based on these inital findings, we proffer a holistic pervasive approach to enable the achievement of value-based, patient-cantred care in chronic disease management. Key lessons include the importance when designing such solutions to focuss on the two primary user groups (patients and clinicians. Clinical Trial: Epworth HREC
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.