Evaluation of an mHealth-enabled hierarchical diabetes management intervention in primary care in China (ROADMAP): A cluster randomized trial

Glycemic control remains suboptimal in developing countries due to critical system deficiencies. An innovative mobile health (mHealth)-enabled hierarchical diabetes management intervention was introduced and evaluated in China with the purpose of achieving better control of type 2 diabetes in primar...

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Bibliographic Details
Published in:PLoS medicine 2021-09, Vol.18 (9), p.e1003754-e1003754
Main Authors: Jia, Weiping, Zhang, Puhong, Zhu, Dalong, Duolikun, Nadila, Li, Hong, Bao, Yuqian, Li, Xian
Format: Article
Language:English
Subjects:
Biology and life sciences
Blood pressure
Body weight
Care and treatment
Cholesterol
Chronic illnesses
Developing countries
Diabetes
Diabetes mellitus (non-insulin dependent)
Diabetes therapy
E-health
Evaluation
Glucose
Glucose monitoring
Health care access
Hemoglobin
Hospitals
Hypoglycemia
Intervention
LDCs
Low density lipoprotein
Medical referrals
Medicine and Health Sciences
Methods
Patients
People and Places
Performance evaluation
Physicians
Primary care
Primary health care
Smartphones
Technology application
Telemedicine
Training
Type 2 diabetes
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Summary:Glycemic control remains suboptimal in developing countries due to critical system deficiencies. An innovative mobile health (mHealth)-enabled hierarchical diabetes management intervention was introduced and evaluated in China with the purpose of achieving better control of type 2 diabetes in primary care. A community-based cluster randomized controlled trial was conducted among registered patients with type 2 diabetes in primary care from June 2017 to July 2019. A total of 19,601 participants were recruited from 864 communities (clusters) across 25 provinces in China, and 19,546 completed baseline assessment. Moreover, 576 communities (13,037 participants) were centrally randomized to the intervention and 288 communities (6,509 participants) to usual care. The intervention was centered on a tiered care team-delivered mHealth-mediated service package, initiated by monthly blood glucose monitoring at each structured clinic visit. Capacity building and quarterly performance review strategies upheld the quality of delivered primary care. The primary outcome was control of glycated hemoglobin (HbA1c;
ISSN:1549-1676
1549-1277
1549-1676
DOI:10.1371/journal.pmed.1003754