Ontology highlight
ABSTRACT: Importance
Patients will decide whether to adopt remote digital monitoring (RDM) for diabetes by weighing its health benefits against the inconvenience it may cause.Objective
To identify the minimum effectiveness patients report they require to adopt 36 different RDM scenarios.Design, setting, and participants
This survey study was conducted among adults with type 1 or type 2 diabetes living in 30 countries from February to July 2019.Exposures
Survey participants assessed 3 randomly selected scenarios from a total of 36. Scenarios described different combinations of digital monitoring tools (glucose, physical activity, food monitoring), duration and feedback loops (feedback in consultation vs real-time telefeedback by a health care professional or by artificial intelligence), and data handling modalities (by a public vs private company), reflecting different degrees of RDM intrusiveness in patients' personal lives.Main outcomes and measures
Participants assessed the minimum effectiveness for 2 diabetes-related outcomes (reducing hypoglycemic episodes and preventing ophthalmologic complications) for which they would adopt each RDM (from much less effective to much more effective than their current monitoring).Results
Of 1577 individuals who consented to participate, 1010 (64%; 572 [57%] women, median [interquartile range] age, 51 [37-63] years, 524 [52%] with type 1 diabetes) assessed at least 1 vignette. Overall, 2860 vignette assessments were collected. In 1025 vignette assessments (36%), participants would adopt RDM only if it was much more effective at reducing hypoglycemic episodes compared with their current monitoring; in 1835 assessments (65%), participants would adopt RDM if was just as or somewhat more effective. The main factors associated with required effectiveness were food monitoring (??=?0.32; SE, 0.12; P?=?.009), real-time telefeedback by a health care professional (??=?0.49; SE, 0.15; P?=?.001), and perceived intrusiveness (??=?0.36; SE, 0.06; P?Conclusions and relevanceThe findings of this study suggest that patients require greater health benefits to adopt more intrusive RDM modalities, food monitoring, and real-time feedback by a health care professional. Patient monitoring devices should be designed to be minimally intrusive. The variability in patients' requirements points to a need for shared decision-making.
SUBMITTER: Oikonomidi T
PROVIDER: S-EPMC7807289 | biostudies-literature | 2021 Jan
REPOSITORIES: biostudies-literature
JAMA network open 20210104 1
<h4>Importance</h4>Patients will decide whether to adopt remote digital monitoring (RDM) for diabetes by weighing its health benefits against the inconvenience it may cause.<h4>Objective</h4>To identify the minimum effectiveness patients report they require to adopt 36 different RDM scenarios.<h4>Design, setting, and participants</h4>This survey study was conducted among adults with type 1 or type 2 diabetes living in 30 countries from February to July 2019.<h4>Exposures</h4>Survey participants ...[more]