An Enhanced SMS-based Support and Reminder Program for Young Adults with Type 2 Diabetes (TEXT2U): Randomized Controlled Trial.

ABSTRACT:

Background

Clinic attendance, metabolic control, engagement in self-management and psychological health are suboptimal in young-onset (<40 years) type 2 diabetes.

Objective

We examined the effectiveness of an enhanced SMS-based support and reminder program in improving clinic attendance, metabolic control, engagement in self-management and psychological health in young-onset type 2 diabetes.

Methods

A twelve-month, parallel-arm, randomized controlled trial comparing an enhanced, semi-personalized SMS-based intervention (incorporating one to eight, supportive and/or informative text messages/month) against standard care was conducted in a specialist, young adult type 2 diabetes clinic. The primary outcome was maintenance of 100% attendance at scheduled quarterly clinical appointments. Secondary outcomes included: (i) metabolic indices, (ii) pathology and self-monitored blood glucose (SMBG) data availability and, (iii) psychosocial well-being.

Results

Forty participants were randomized and 32 completed their 12-month study visit. Average participant age was 32.7±5.1 years, 50% were male, and baseline HbA1c was 7.3±1.9% (56±20 mmol/mol). A higher proportion of the intervention group achieved 100% attendance (57% vs 26% control); Kaplan-Meier analysis demonstrated significantly greater cumulative attendance in the intervention group (P=.04). There were no between-group differences in HbA1c, BMI, lipids or availability of pathology and SMBG data. Odds of recording an improvement in Diabetes Empowerment Scale-Short Form score were higher in the intervention group at six months [OR 4.3 (1.1-17)] with attenuation of effect at study end [OR 3.1 (0.9-11)]. Program acceptability was high; >90% of participants would recommend the program to new patients.

Conclusions

An enhanced SMS-based support and reminder program doubled scheduled attendance rates for young-onset type 2 diabetes. The program was highly acceptable, provided early support for patient empowerment but had no significant effect on measures of metabolic control or self-management.

Clinicaltrial

Australian and New Zealand Clinical Trials Registry (ACTRN12618000479202).

SUBMITTER: Middleton T 

PROVIDER: S-EPMC8569538 | biostudies-literature |

REPOSITORIES: biostudies-literature