Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Oct 29, 2020
Date Accepted: Jan 13, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness of Family Portal Function on Lilly Connected Care Program (LCCP) in Patients with Type 2 Diabetes: a Retrospective Cohort Study with Propensity Score Matching
ABSTRACT
Background:
Diabetes is a major health concern worldwide. Family member engagement in diabetes self-management education programmes can improve patients’ diabetes management. However, there is limited evidence that the family portal on diabetes management apps is effective in the glycaemic control of patients with diabetes.
Objective:
We aimed to evaluate the effectiveness of family support through the family portal function on Lilly Connected Care Program® (LCCP®) platform.
Methods:
This retrospective cohort study included patients with type 2 diabetes (T2DM) recruited to the LCCP platform from September 1, 2018 to August 31, 2019. Propensity score matching was used to match family (group A) and non-family (group B) portal use groups with similar baseline characteristics. The patients were followed up for 12 weeks. The main objectives were differences in mean fasting blood glucose (FBG), proportion of patients achieving FBG target < 7mmol/L, mean postprandial blood glucose (PBG), proportion of patients achieving PBG target <10mmol/L, proportion of patients achieving both FBG <7mmol/L and PBG <10mmol/L, self-monitoring of blood glucose (SMBG) frequency at week 12 and the number of diabetes education courses patients completed during the 12 weeks. Moreover, logistic regression analysis was used to explore the baseline factors which may be associated with the use of family portal, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.
Results:
A total of 6582 adult patients (aged ≥18 years) with T2DM who were treated with insulin were enrolled in the study. Overall, 6.1% (402/6582) of the patients chose to engage their family members to use the family portal. Two groups of 394 patients were well-matched regarding baseline characteristics. After matching, mean FBG and PBG at week 12 were significantly lower in group A than group B (FBG, 7.12 ± 1.70 mmol/L vs. 7.42 ± 1.88 mmol/L, P = .02; PBG, 8.56 ± 2.51 mmol/L vs. 9.10 ± 2.69 mmol/L, P = .002). The proportion of patients achieving both FBG <7mmol and PBG <10mmol/L at week 12 (46.8% vs. 39.4%, P=.04), SMBG frequency at week 12 (8.92 ± 6.77 vs 8.02 ± 5.97 times per week, P = .05) and number of diabetes education courses completed in 12 weeks (23.00 [interquartile range (IQR) 9.00-38.00] vs 15.00 [IQR 4.00-36.00], P<.001) were higher in group A than group B. Besides, multivariate logistic regression analysis showed that higher age (OR=0.987, P=.006) and higher baseline FBG (OR=0.914, P=.004) were correlated with less use of family portal function, while increased baseline SMBG frequency (OR=1.022, P<.001) as well as increased education courses (OR=1.026, P<.001) were associated with more of using family portal function.
Conclusions:
Family support through the LCCP family portal is effective for glycaemic control and self-management behaviour improvement in T2DM patients.
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