JMIR Publications

ABSTRACT

Background:

Collaboration between people with type 2 diabetes (T2DM) and their health care teams is important for optimal control of the disease and outcomes. Digital technologies have the potential to tie together several health care-related devices and platforms into connected ecosystems (CES), but attitudes about CES are unknown.

Objective:

We surveyed convenience samples of patients and physicians to better understand which patient characteristics are associated with higher likelihoods of 1) participating in a potential CES program, as self-reported by T2DM patients and 2) clinical benefit from participation in a potential CES program, as reported by physicians.

Methods:

Adults who self-reported a diagnosis of T2DM and current insulin use (n=197), and 33 physicians whose practices included ≥20% of such patients, were enrolled in the U.S., France, and Germany. We surveyed both groups about the likelihood of future patient participation in a CES. We then examined the associations between patients’ clinical and sociodemographic characteristics and this likelihood. We also described the characteristics of patients likely to clinically benefit from CES use, according to the physicians.

Results:

Compared with patients in Germany and France, US patients were considerably younger (mean age, 45.3 years vs. 61.9 and 65.8 years, respectively), more often female, more highly educated, and more likely to be working full-time. In all, 44.7% of US patients, 36.4% of German patients, and 46.3% of French patients indicated strong interest in a CES program, and 78.7% reported currently using ≥1 connected device or app. However, physicians believed that only 11.3%–19.2% of their patients were using connected devices or apps to manage their disease. Physicians also reported infrequently recommending or prescribing connected devices to their patients, although ≥80.0% of them thought that a CES could help support their patients in managing their disease. The factors most predictive of patient likelihood of participating in a CES program were cost, inclusion of medication reminders, and linking blood glucose levels to behaviors such as eating and exercise. In all countries, the most common patient expectations for a CES program were that it could help them eat more healthfully, increase their physical activity, increase their understanding of how blood glucose relates to behavior such as exercise and eating, and reduce stress. Physicians thought that newly diagnosed patients, sicker patients—those who had been hospitalized for diabetes, were currently using insulin, or who had any comorbid condition—and patients who were non-adherent to treatment were most likely to benefit from CES use.

Conclusions:

In this study, there was a high degree of interest in the future use of CES, although additional education is needed among both patients with T2DM and their physicians to achieve the full potential of such systems to improve self-management and clinical care for the disease. Clinical Trial: n/a