Therapeutic impact of an intervention associating pharmacist counseling and the use of a mobile health application for type 2 diabetes patients

Background and objective:
Prevalence of type 2 diabetes is high in Belgium (estimated at over 8%, 1 patient out of 3 being unaware of their diagnosis). This study aims at exploring the benefits of the use of mobile technologies combined with health coaching by the community pharmacist to help diabetes patients with their daily life and disease management. The intervention aimed to reinforce the patient's willingness to actively participate in the management of their disease and to adopt favorable health behaviors, in order to increase their level of therapeutic adherence.

Setting and method:
Interventional study combining educational intervention and coaching by the community pharmacist with the use of a mobile health application provided by Comunicare.
Quantitative pre-experimental study over a period of six months with three data collection periods (before, during and after the intervention).

Main outcome measures:
Primary outcomes (HbA1c and MARS-5 score) correlate to the level of therapeutic adherence, and secondary outcomes (HDL cholesterol, LDL cholesterol, systolic and diastolic blood pressure, BMI and waist circumference), were judged to be good indicators for further follow-up of the diabetic patient.

Results:
The baseline sample consisted of 66 patients, 50 of whom completed the study. Statistical analyses did not show an improvement in the level of medication adherence. However, significant results were observed for systolic blood pressure and waist circumference (both improving). All the other outcomes, including HbA1c, changed positively or stabilized between the beginning and end of the study.

Conclusions:
This study showed that counseling by the community pharmacist, combined with the use of a mobile health application, can achieve the therapeutic intent of physician-initiated therapy and have a positive impact on the management of the type 2 diabetic patients as well as on outcomes considered as cardiovascular risk factors.