Improving diabetes self-care with a PDA in ambulatory care
Improving diabetes self-care with a PDA in ambulatory care
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DOI：
10.1089/tmj.2007.0053
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发表时间：
2008-04-01
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影响因子：
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通讯作者：
Ory, Marcia G.
中科院分区：
文献类型：
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作者：
Forjuoh, Samuel N.;Reis, Michael D.;Ory, Marcia G.
在糖尿病管理中使用信息技术已被证明可以改善自我护理。我们确定了患者在门诊环境中使用个人数字助理(PDA)加强2型糖尿病(T2 DM)自我护理是否会改善血糖控制。一项前测/后测干预研究在一个拥有186,000名成员的健康维护组织的大型多专科小组实践中，在四个家庭诊所进行。患有T2 DM且最近一次测量糖化血红蛋白(HbA1c)为8.00%的成年人接受了一对一的培训，学习如何使用预先安装了“糖尿病飞行员”的借来的PDA。所有参与者的HbA1c和其他结果的变化在6个月后被评估，根据参与者报告的PDA使用模式，分为PDA使用率高(过去7天=3天)和PDA使用率低(<3天)。在43名受试者中，18人(41.90%)完成了为期6个月的干预。他们的平均HbA1c从基线的9.70%下降到8.00%，下降了17.50%，平均HbA1c变化-1.7%(95%CI=-2.60~-0.90)。高PDA组的HbA1c平均变化(n=9，平均差=-1.90，95%CI=-3.20~-0.50)高于低PDA组(n=9，平均差=-1.50，95%CI=-2.80~-0.30)。据报道，糖尿病自我护理活动摘要的足部护理和一般饮食分量表从3个月到6个月显著增加。携带PDA的成年人加强T2 DM自我护理与显著降低HbA1c有关；在报告的高PDA使用者中，下降幅度更大。
Use of information technology in diabetes management has been shown to improve self-care. We determined whether enhancing type 2 diabetes (T2DM) self-care with a personal digital assistant (PDA) by patients in the ambulatory setting would improve glycemic control. A pretest/ posttest intervention study was conducted in four family practice clinics in a large multispecialty group practice associated with an 186,000-member Health Maintenance Organization. Adults with T2DM and last measured glycosylated hemoglobin (HbA1c) of >= 8.00% received one-on-one training on the use of a loaned PDA pre-installed with " Diabetes Pilot." Changes in HbA1c and other outcomes were assessed at 6 months from baseline for all participants and by participant-reported PDA use patterns, dichotomized into high PDA users (>= 3 days in past 7) and low PDA users (< 3 days). Of 43 subjects enrolled, 18 (41.90%) completed the 6-month intervention. Their mean HbA1c decreased 17.50% from 9.70% at baseline to 8.00%, a significant mean HbA1c change of -1.7% (95% CI = -2.60 to -0.90). The mean HbA1c change was higher among reported high PDA users (n = 9, mean difference = -1.90, 95% CI = -3.20 to -0.50) than among reported low PDA users (n = 9, mean difference = -1.50, 95% CI = -2.80 to -0.30). Significant increases were reported for the foot care and general diet subscales of the Summary of Diabetes Self-Care Activities from 3 to 6 months. Enhancing T2DM self-care by adults with a PDA was associated with significant reductions in HbA1c; the reductions were greater among reported high PDA users.