James E. Aikens|Ranak Trivedi|David C. Aron|John D. Piette
Integrating Support Persons into Diabetes Telemonitoring to Improve Self-Management and Medication Adherence
University of Michigan–Ann Arbor|VA Palo Alto Health Care System|Center for Innovation|Case Western Reserve University|VA Center for Clinical Management Research
purpose study investigate potential benefits medication adherence integrating patientselected support person automated diabetes telemonitoring selfmanagement program determine whether benefits vary patients baseline level psychological distressthe study quasiexperimental patient preference trialthe study included patients type 2 diabetes participated three six months weekly automated telemonitoring via interactive voice response ivr calls option designating supportive relative friend receive automated updates patients health selfmanagement along guidance regarding potential patient assistance measured longterm medication adherence using fourpoint morisky medication adherence scale mmas4 possible range 04 weekly adherence ivr item psychological distress baseline mental composite summary mcs sf12of 98 initially nonadherent patients 42 opted involve support person participants support person demonstrated significantly greater improvement longterm adherence participated alone linear regression slopes 117 vs 057 respectively p 0001 among distressed patients particular odds weekly nonadherence tended decrease 25 per week support person p 0030 yet remained high participated alone p 0820despite multiple challenges illness selfmanagement patients diabetes nonadherent psychologically distressed may benefit incorporation support person receive assistance via automated telemonitoring