Feasibility study of automated interactive voice response telephone calls with community health nurse follow-up to improve glycaemic control in patients with type 2 diabetes.
Panan Pichayapinyo, Laura R Saslow, James E Aikens and 4 others
PMID 31531929WHAT IT FOUND
In 35 Thai adults with poorly controlled type 2 diabetes, group education, weekly automated calls, a health log, nurse follow-up, and possible medication changes were linked to a mean 0.9% HbA1c drop over 12 weeks, but there was no control group.
Key findings
01At the end of 12 weeks, mean HbA1c had fallen by 0.9% and mean fasting blood glucose had fallen by 14.9 mg/dL, but there was no control group.
02The feasibility pilot analysed 35 patients after 1 withdrawal, and patients completed calls in 71% of attempted weeks.
03Patients were very satisfied, but only 33% of nurses were willing to continue using the system or recommend it, and nurses reported email burden.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
There was no control group, so the observed changes could reflect time, repeated assessment, or increased clinical attention. The study was designed for feasibility with 36 patients and 6 nurses, so it may not have had enough power to detect differences reliably. Patients received group education, a health log booklet, automated calls, nurse follow-up, and some had medication changes, so the contribution of any single component cannot be separated. Most participants were older suburban women with low educational levels, so results may not generalise to other groups. Nurses reported email burden, and only 33% were willing to continue or recommend the system, so scaling may be difficult. The IVR system had early technical problems, and 16.9% of patients reported unintentionally disconnecting at least one call.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude the automated calls alone improved blood sugar. Patients also received group education, a health log booklet, nurse follow-up, and some had medication changes, and the study had no control group.