Empowering patients with diabetes by monitoring daily activities using a home activity monitoring system: a feasibility study

Jesús González-Lama, Pedro José Mompeán-Torrecillas, Macarena Espinilla-Estévez, Matilde Romero-López, David Díaz-Jiménez, Nicomedes Rodríguez-Rodríguez, David Pérez-Cruzado

Keywords: diabetes mellitus; e-health; health behavior; self-care

Background:

Following healthy lifestyle behaviours (HLBs) is essential to prevent the complications of type 2 diabetes (T2DM). Involving the patient and helping them to follow up over time is key. A non-invasive home monitoring system (NIHMS) could help achieve this goal.

Research questions:

Will a NIHMS be feasible, and will it help to follow the HLBs agreed with the patient with T2DM, resulting in improved clinical targets?

Method:

A pilot feasibility randomised controlled trial (RCT) was conducted in 21 patients with T2DM attending a primary care centre (10 intervention/11 control group). AI2EPD is an activity monitoring solution that reports the daily activities. Both monitoring and activity recognition are performed transparently and frees the user from direct interaction with the devices, using sensors installed at home (motion, opening/closing and environment), and an activity wristband. Its main objective is to provide feedback on compliance with the agreement signed prior to the study on treatment, meals, exercise, and other lifestyle recommendations. Data on knowledge of diabetes management and clinical variables such as HbA1c and lipids, were collected at baseline and after 6 months. At the end of the study, satisfaction with the tool in the intervention group (IG) was assessed using a System Usability Scale (10 items with five response options, from ‘Strongly agree’ to ‘Strongly disagree’).

Results:

Subjects in the IG found the system easy to use (mean 4.2, CI95% 3.46 to 4.94), and felt very confident using the system (mean 4.2; CI95% 3.75 to 4.65). Improvements in abdominal circumference and amount of exercise were observed in IG subjects, without reaching statistical significance.

Conclusions:

The AI2EPD system was found to be viable and very well accepted. Despite the small sample size and short follow-up, there was a trend towards improvement in healthy behaviours and most clinical variables.

Points for discussion:

Do patients accept the use of minimally invasive technology in their homes for medical supervision and self-monitoring?

What are the challenges you anticipate for the conduct of a randomised clinical trial in your setting to study whether the AI2EPD system can improve adherence to healthy lifestyles in patients with T2DM?

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