Impact
of Computer-Generated Personalized Goals on HbA1c
Vast
majority of patients with diabetes do not know their
HbA1c status or goal.
The
public is increasingly aware of the importance of HbA1c
testing. We set forth to evaluate the impact of a
system that provides uniquely formatted and personalized
reports of diabetes status and goals on changes in HbA1c
levels.
A
total of 150 patients with diabetes were randomized to
receive either standard care or intervention inclusive
of a computer-generated 11" x 17" color poster
depicting an individual’s HbA1c status and goals
along with personalized steps to aid in goal achievement.
All patients enrolled received diabetes education
during the 3 months before enrollment. HbA1c
was performed at baseline and 6 months.
The
study found at baseline, there were no significant differences
between patient groups in terms of age, sex, education
level, race, and HbA1c or lipid levels.
Among patients with baseline HbA1c
7.0%,
there was an 8.6% (0.77% absolute) reduction in HbA1c
among control subjects compared with a 17.0% (1.69% absolute)
decline in the intervention group (P = 0.032). There
were no differences between the control and
intervention groups with respect to the frequency of
patients experiencing any decline in HbA1c
(63 vs. 69%, P = 0.87); among these patients experiencing
a decline, the most substantial reductions were seen with
the control group, which had a 13.3% (1.15% absolute)
decline compared with the intervention patients, who
reduced their HbA1c by 24.2% (2.26% absolute
reduction; P = 0.0048). At study close, 77% of
the patients had their poster displayed on their refrigerator.
The
study concluded that this unique and personalized
computer-generated intervention resulted in HbA1c
lowering comparable to that of hypoglycemic agents.
Department
of Internal Medicine, Division of Endocrinology, Washington
Hospital Center, Washington, DC. 2 MedStar Research
Institute, Washington, DC.
News
Flash:
Doctors
warn that up to 13 million more are at risk for developing the
deadly illness, advanced kidney disease and they don't even know
it. In its early stages, kidney disease has almost no symptoms,
explains Dr. William Keane, president of the National Kidney
Foundation. Source:
HealthSCOUT Publication date: 2002-04-13
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