A smartphone app providing health education and medication reminders reduced HbA1c at 6 months compared to conventional education (MD -0.13; 95% CI -0.25 to -0.01; P=.04).
RCT (n=1,066)
Open-label
Yes
Does a smartphone app-based health education and medication reminder system improve HbA1c in post-CABG patients with diabetes?
A smartphone app-based intervention provided a statistically significant but clinically modest reduction in HbA1c at 6 months in post-CABG patients with diabetes.
Mean Difference: -0.13 (95% CI -0.25–-0.01)
p-value: p=.04
Abstract Background Despite the growing amount of patients who underwent coronary artery bypass grafting (CABG) in low- and middle-income countries like China, their glucose control was suboptimal, likely due to poor adherence to healthy lifestyles and preventive medications. Mobile health tools facilitating secondary prevention seem promising, but evidence focusing on this high-risk population is scarce. Objective This study aimed to evaluate the significance of mobile health tools in long-term glycemic management for post-CABG patients with comorbid diabetes mellitus. Methods GUIDEME (glycemic control using mini program–based intervention in patients with diabetes undergoing coronary artery bypass to promote self-management) is a multicenter, open-label, closed-user group, randomized controlled trial, in which 1066 patients with diabetes who had recently undergone CABG were enrolled and allocated into 2 groups. Patients in the control group received conventional health education before discharge, whereas those in the intervention group additionally received automatic delivery of bite-sized health education and medication reminders through a smartphone app during the 6 months after discharge. The primary end point was a change in glycosylated hemoglobin (HbA 1c ) from baseline to 6 months. Results Among the 1066 eligible participants enrolled, a total of 1038 (97.4%) had completed the follow-up, while 1000 (93.8%) had 6-month HbA 1c results available. Although only 79 (14.9%) patients in the intervention group were defined as active users, a greater reduction of HbA 1c in the intervention group was observed (adjusted between-group mean difference −0.13, 95% CI −0.25 to −0.01; P =.04). The intervention group also had a high proportion of good medication adherence (96.1% vs 93.2%, P =.04). There was no difference between the 2 groups regarding the secondary end points. Conclusions Health education and medication reminders based on smartphone app achieved a statistically significant but modest between-group difference in HbA 1c , the clinical relevance of which remains uncertain.
Song et al. (Tue,) conducted a rct in Diabetes mellitus in patients post-coronary artery bypass grafting (n=1,066). Smartphone app-based health education and medication reminders vs. Conventional health education before discharge was evaluated on Change in glycosylated hemoglobin (HbA1c) from baseline to 6 months (MD -0.13, 95% CI -0.25 to -0.01, p=.04). A smartphone app providing health education and medication reminders reduced HbA1c at 6 months compared to conventional education (MD -0.13; 95% CI -0.25 to -0.01; P=.04).
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