“Work Differently” for Improved Diabetes Outcomes
[Author:
ALLISON CUTTS | Executive Director, Business Development and Sales – Patient Support Solutions]
Summary of Themes Shared
Diabetes is an ongoing and growing condition affecting millions of people worldwide. To combat the global impact of this disease on patients, we need to put the focus more on patient barriers, diabetes care management, digital technologies, and “Working Differently” to improve patient engagement and clinical outcomes.
Global Impact
The diagnosis of people with diabetes continues to grow as the World Health Organization (WHO) reported in September 2022. From 2000 to 2019, there was a 3% increase in mortality rates related to diabetes. Earlier this year, the Center for Disease Control and Prevention (CDC) released the National Diabetes Statistics Report estimating more than 130 million adults are living with diabetes or prediabetes in the United States. The report indicated that an estimated 1.4 million new cases of diabetes were diagnosed among people ages 18 and older in 2019. People with diabetes were highest among [1]:
- American Indian and Alaska Native persons (14.5%)
- Non-Hispanic Black people (12.1%)
- People of Hispanic origin (11.8%)
- Non-Hispanic Asian people (9.5%), and
- Non-Hispanic White people (7.4%)
In addition, adults at risk with a family income below the federal poverty level have the highest prevalence of diabetes in both men (13.7%) and women (14.4%), and people with less education were more likely to have diagnosed diabetes. [2]
This report demonstrates that there is clearly much work to be done. While the need and opportunity to support people with diabetes is expansive, it is also attainable, especially through digital tools and solutions and innovative collaboration.
Patient Barriers to Success
While improvements in the treatment and care of patients with Type 2 Diabetes (T2D) are possible, that doesn’t dismiss the fact that the barriers to successful management of this disease are numerous and can be overwhelming to patients. The 2021 Journal of Medicines Optimization article “Optimizing medicines vs. supporting people” written by Mark Duman highlights these challenges [3]. He indicates that there is a 50% failure rate of people with diabetes taking their medications as prescribed. In most cases, the pharmacy is the last point of contact with or for patients, leaving them to manage their chronic, complex condition on their own. In fact, ongoing care for diabetes patients by providers, caregivers and the patient’s broader care team is challenged with not fully understanding (i) the patient’s ability (or lack thereof) to strive for better health outcomes, (ii) how to fully support the patient’s lack of knowledge of the benefits of maintaining a consistent regimen around the complexities of diabetes care, and (iii) the personalized needs of each patient. [3]
Additionally, patients diagnosed with diabetes are faced with not only managing this challenging illness, but also a chronic condition that can cause serious complications. Common health complications may include heart disease, chronic kidney disease, nerve damage, and other problems with feet, oral health, vision, hearing, and mental health.
Furthermore, the stigma around people with diabetes exists and is oftentimes due to lack of information and support. Patients with diabetes may feel excluded, rejected, or blamed for their condition. The internalization of false beliefs related to this mistaken stigma may cause patients to feel guilt and shame, which can lead to depression and anxiety, due to assumptions that patient hasn’t eaten “right” or exercised enough [4]. The stigma can be a major challenge in the patient’s mental health, especially when it can be found anywhere, including in the family, school, workplace, and healthcare setting.
Potential Strategies for to Support Patients with Diabetes
The management of T2D typically focuses on:
- Diabetes medication or insulin therapy
- Blood sugar monitoring
- Healthy eating
- Regular exercise
- Weight loss
To successfully create strategies to support patients with T2D, we need to truly understand the patient’s journey, beyond just the medication. To do so, it is important to understand:
- The individual patient’s experience, situation, and psychosocial and behavioral barriers to personalize support
- Patients who can educate themselves and participate in active in information sharing related to their care, provides the opportunity to align patient support programs to meet their needs to drive stronger outcomes
- Measuring more than just BMI and HbA1c will help to better understand necessary patient lifestyle improvements, and/or other prescribed medications
- The need to remove language barriers, as alignment with the patient’s primary language will aid in enhancing education and open-up barriers of communication and understanding
- Care coaches and digital programs encourage patients to be proactive and improve their understanding of self-care, self-management, and prevention [3].
While there are many potential strategies to support patients with diabetes, focusing on the following areas, as suggested by the American Diabetes Association, can make a huge impact on improving patient outcomes [7].
(i) Enhance and optimize the care team’s approach
The care team should prioritize timely and appropriate support around lifestyle and/or drug therapy for patients who have not achieved beneficial levels of glucose, blood pressure, or lipid control. Strategies such as:
- explicit goal setting with patients,
- identifying and addressing language, numeracy, or cultural barriers to care,
- integrating evidence-based guidelines and clinical information tools into the process of care, and
- incorporating care management teams including nurses, pharmacists, and other providers.
(ii) Support Patient Behavior Change
Effective diabetes care requires an organized approach to strengthen patients’ behavior change efforts, including:
- Healthy lifestyle choices, including physical activity, healthy eating, tobacco cessation, weight management, and effective coping,
- Disease self-management around taking and managing medications and, self-monitoring of glucose and blood pressure,
- Prevention of diabetes complications by self-monitoring of foot health; active participation in screening for eye, foot, and renal complications; and immunizations, and
- High-quality diabetes self-management education has been shown to improve patient self-management, satisfaction, and glucose control, as it utilizes an integrated approach including clinical content and skills, behavioral strategies, and engagement with psychosocial concerns.
In addition, this type of patient care is gaining traction, as healthcare organizations to continue to move towards a focus on value- or outcomes-based solutions, which allows for a measured clinical and behavioral, financial impact and not just what is being supplied to patients [3].
The current standard of care has not typically focused on patient behavior and/or clinical outcomes related to diabetes care management due to the complexity and various co-morbidities such patients are face with while managing their care. However, technology, when implemented and deployed well, can greatly assist patients and healthcare providers in “Working Differently.” But specifically, how can digital solutions help patients overcome the barriers of T2D and in turn, improve outcomes and reduce the cost of managing their condition?
Digital tools continue to be evaluated to support the initiation and/or optimization of insulin therapy. Technologies providing a patient-centric approach to connecting glucose monitoring, dose recording, and titration advice, as well as documenting co-morbidities and lifestyle factors can help l to reduce the complexity and burden of treatment, while significantly improving patient outcomes [5].
Digital technology has the ability to customize and personalize programs to include reminders, dosing and administration information, lifestyle programs, diet support, disease education, caregiver and care team interactions, gamification and more.
Digital medicine, digital research, machine learning, and artificial intelligence (AI) provide the opportunity to transform the field of diabetes with a real-time focus on actionable data to assist in remote monitoring of patients’ symptoms, physiological data, behaviors, and social environments. Capturing data through wearables, sensors, and/or smart phone technologies, along with patient proactive engagement and feedback, is a powerful combination that can identify patterns of risk that ultimately combined with clinical data, can improve the quality of life, and prevent future complications related to diabetes management [6].
The effective management of Type 2 Diabetes requires accurate capturing of data, integration with the patient’s care team, as well as curated patient education and self-management training. Newer technologies are focused collecting data in real time, improving workflow to automate transfer of patient data, and integrating multiple data sources, all of which provides immediate and personalized patient care. Additional “evidence has suggested that technology in which people with diabetes can request the involvement of an HCP might be more appealing than those without this feature”. In addition, for health technology to be truly effective, it should be readily available, easy to use, and minimize challenges related to cognitive ability, health literacy, or manual dexterity [5].
Successful integration of new digital technology while aligning capabilities, and integration with existing technology investments is key to creating a fluid digital ecosystem. Supporting individualized patient care plans while creating a meaningful experience that is simple and captures real-time patient outcomes and behaviors is a win-win for patients and providers alike. Many patients with diabetes require a more hands-on approach regarding their medications, emotional needs, and adherence than today’s healthcare providers can provide. Deploying digital technologies that are easily integrated and shared with the patient’s care team helps enhance the provider workflow while collaboratively managing clinical goals and resources. Digital technologies provide the opportunity to deliver a focused approach to improve the patient and provider experience, which ultimately leads to a successful diabetes patient support program.
How to “Work Differently” with Diabetes Care to Improve Outcomes
Pharmaceutical companies, healthcare providers, payers, and support organizations are all exploring new and better ways to help diabetes patients to improve disease education, engagement in care management programs, and clinical outcomes.
To support these efforts, Medocity, an innovative, patient-focused health technology company, provides digital solutions for diabetes care and ongoing disease management. We engage patients throughout their disease journey and enable the capture of continuous patient-centered data. Accessible in real time on any device, our technology is interoperable and swift in implementation, while seamlessly integrating hundreds of connected sensors and wearables, data sources, systems, and vendors. Medocity’s solutions increase retention and compliance, improve outcomes, and lower healthcare costs.
The Medocity Platform’s integrated, end-to-end solution uniquely enables the following key capabilities to support diabetes patient support programs:
- Real-time data capture and actionable alerts related to diabetes care management programs individualized to patients current and ongoing care needs
- Universal access and seamless connectivity for all stakeholders, which creates a digitally integrated ecosystem of patients, healthcare providers, caregivers, pharmacies, hub programs, support organizations, and/or labs, etc.
- Remote monitoring, real-time intelligence, and meaningful interventions to track key vital signs, medications, diet, exercise, periodic health assessments, CGMs, glucometers, and goals and tasks
- Curated resources for patients, caregivers, and other stakeholders with timely screening for behavioral modification and prompt educational guidance on correlation of glucose levels with patients.
- Proactive and predictive nudges to achieve fewer or less severe diabetes-related complications
- Clinically and commercially validated high patient engagement and satisfaction rates to align with ongoing goals, expansion of care, and social support programs
- Personalized guided sessions to collect data through a wizard-like experience, simplifying patient’s tasks, increasing engagement, assisting with behavioral modifications, and prompting educational guidance on correlation of key actionable data
- Real-time patient reminders to improve reporting compliance and medication adherence
Medocity’s truly patient-centric platform creates a full continuum of diabetes support by integrating patients in real time with their stakeholders in care and relevant data sources to create a personalized, interactive care experience throughout their care journey.
To learn more about how Medocity is helping life science companies to “Work Differently” with our digital patient-centric care connected ecosystems, contact Allison Cutts at acutts@medocity.com.
Reference Articles:
[1] World Health Organization: https://www.who.int/news-room/fact-sheets/detail/diabetes
[3] Journal of Medicines Optimization: https://www.pmhealthcare.co.uk/uploads/mediacentre/JOMO_December_2021_V4.pdf
[4] Mental Health Spotlight: Dealing with Type 2 Diabetes Stigma, Blame and Shame: https://www.healthline.com/health/type-2-diabetes/dealing-with-stigma-blame-shame#reasons-for-stigma
[5] New Digital Health Technologies for Insulin Initiation and Optimization for People With Type 2 Diabetes: https://www.sciencedirect.com/science/article/pii/S1530891X22004840
[6] Digital Diabetes: perspective for diabetes prevention, management, and research: https://bit.ly/3Ey80Tj
[7] American Diabetes Association: Strategies for Improving Care: https://bit.ly/3UHgJIy
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