A new study by the Veterans Affairs Ann Arbor Healthcare System and University of Michigan suggests that mobile phones could help low-income patients across the globe manage diabetes and other chronic diseases.
“Telehealth programs have been shown to be very helpful in a variety of contexts, but one of the main limitations for delivering these services in the developing world has been a lack of infrastructure,” John D. Piette, PhD, senior research scientist with the VA, professor of internal medicine at the University of Michigan Medical School and lead study author, stated in a press release.
For this study, researchers took advantage of the broad penetration of cell phones in Latin America and paired them with low-cost internet-based phone calls. The service used a cloud computing approach so that the program can be provided from a central location to low income countries around the globe that lack a strong technological infrastructure.
To test the service, the researchers enrolled patients with diabetes from a clinic in a semi-rural area of Honduras. Patients received weekly, automated, interactive phone calls and overwhelmingly reported that the program helped them to improve their diabetes management and general health.
Over the 6-week study, researchers saw a clinically important improvement in patients’ hemoglobin A1C, a measure of blood sugar control.
“We wanted to demonstrate that it was possible to deliver a high-tech program from University of Michigan to very vulnerable patients with diabetes in Honduras who only have local cell phone service,” Piette stated.
Worldwide, the number of people with diabetes is expected grow from 285 million to 439 million by 2030. The patients who used the program the most were the ones who had higher blood pressure at the outset, had more severe diabetes and lived farther away from the clinic, according to Piette.
On average, the patients in the study had only 5 years of formal education and annual household incomes of $2,500. Patients also had the option of enrolling in the program with an informal caregiver or care partner, who also received calls to their cell phones informing them of how the patient was doing and providing suggestions for how they could help support the patient’s self-care.
Future research will examine the program’s success against a control group and extend the study period over a longer time period, according to Piette.
