Personalized Feedback in Diabetes Self-Management Not Always Effective

Lead author, Dr. Diana Sherifali wrote, "It's possible the messages weren't powerful enough or that paper-based feedback may have been too passive." 

"This study highlighted that the message needs to be meaningful and deemed important enough for people to act upon."

Dr. Sherifali of McMaster University, Hamilton, Ontario and colleagues had hoped that information specific to a particular individual might help that person achieve better health outcomes than would widely available generic information.

They recruited 465 participants from the ranks of an existing community-based diabetes support program, with a mean age of 62 and a mean hemoglobin A1C of 7.83%.

After patients completed a questionnaire, the researchers randomly assigned them to receive, or not receive, periodic computer-generated, evidence-based feedback by mail. Patients in the intervention group received up to 20 automatically generated recommendations for glycemic control and other aids based on questionnaire responses and A1C levels.

At one year, A1C had fallen by 0.24% in the intervention group and 0.15% in controls. The difference was not significant.

In addition, there was no between-group difference in measures of quality of life, diabetes self-management behaviors, or clinical outcomes.

The researchers offer a number of possible explanations for this finding. Among these is that, "Any incremental benefit of the intervention studied in this trial may have been insufficient to surpass the effect of the community-based program alone."

"Future research," Dr. Sherifali added, "may investigate the mode of delivering feedback (social networking, email, texts) and the intensity of the message (greater emphasis on individualizing feedback) to determine the impact on overall management."

Diabetes Care online June16, 2011