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基于既定指南设计的支持 2 型糖尿病自我管理的智能手机应用程序 SMC-01 的疗效:随机对照试验。

Efficacy of Save Medical Corporation (SMC)-01, a Smartphone App Designed to Support Type 2 Diabetes Self-Management Based on Established Guidelines: Randomized Controlled Trial.

机构信息

Donald and Barbara Zucker School of Medicine, Hempstead, NY, United States.

Department of Planning, Information and Management, University of Tokyo Hospital, Tokyo, Japan.

出版信息

J Med Internet Res. 2024 Sep 10;26:e53740. doi: 10.2196/53740.

Abstract

BACKGROUND

Lifestyle modifications are a key part of type 2 diabetes mellitus treatment. Many patients find long-term self-management difficult, and mobile apps could be a solution. In 2010, in the United States, a mobile app was approved as an official medical device. Similar apps have entered the Japanese market but are yet to be classified as medical devices.

OBJECTIVE

The objective of this study was to determine the efficacy of Save Medical Corporation (SMC)-01, a mobile app for the support of lifestyle modifications among Japanese patients with type 2 diabetes mellitus.

METHODS

This was a 24-week multi-institutional, prospective randomized controlled trial. The intervention group received SMC-01, an app with functions allowing patients to record data and receive personalized feedback to encourage a healthier lifestyle. The control group used paper journals for diabetes self-management. The primary outcome was the between-group difference in change in hemoglobin A from baseline to week 12.

RESULTS

The change in hemoglobin A from baseline to week 12 was -0.05% (95% CI -0.14% to 0.04%) in the intervention group and 0.06% (95% CI -0.04% to 0.15%) in the control group. The between-group difference in change was -0.11% (95% CI -0.24% to 0.03%; P=.11).

CONCLUSIONS

There was no statistically significant change in glycemic control. The lack of change could be due to SMC-01 insufficiently inducing behavior change, absence of screening for patients who have high intention to change their lifestyle, low effective usage of SMC-01 due to design issues, or problems with the SMC-01 intervention. Future efforts should focus on these issues in the early phase of developing interventions.

TRIAL REGISTRATION

Japan Registry of Clinical Trials jRCT2032200033; https://jrct.niph.go.jp/latest-detail/jRCT2032200033.

摘要

背景

生活方式的改变是治疗 2 型糖尿病的关键部分。许多患者发现长期自我管理困难,而移动应用程序可能是一种解决方案。2010 年,在美国,一款移动应用程序被批准为官方医疗设备。类似的应用程序已经进入日本市场,但尚未被归类为医疗设备。

目的

本研究旨在确定 SMC-01 移动应用程序在支持日本 2 型糖尿病患者生活方式改变方面的疗效。

方法

这是一项 24 周的多机构、前瞻性随机对照试验。干预组使用 SMC-01,这是一款具有允许患者记录数据和接收个性化反馈以鼓励更健康生活方式的功能的应用程序。对照组使用糖尿病自我管理的纸质日记。主要结局是从基线到 12 周时血红蛋白 A 的组间变化差异。

结果

干预组从基线到 12 周时血红蛋白 A 的变化为-0.05%(95%置信区间-0.14%至 0.04%),对照组为 0.06%(95%置信区间-0.04%至 0.15%)。组间变化差异为-0.11%(95%置信区间-0.24%至 0.03%;P=.11)。

结论

血糖控制没有统计学上的显著变化。变化不明显可能是由于 SMC-01 不足以引起行为改变,对有强烈改变生活方式意愿的患者没有进行筛选,由于设计问题导致 SMC-01 的有效使用不足,或者 SMC-01 干预存在问题。未来的努力应集中在这些问题上,以在干预的早期阶段进行开发。

试验注册

日本临床试验注册处 jRCT2032200033;https://jrct.niph.go.jp/latest-detail/jRCT2032200033。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1b/11429663/6f2056932bbc/jmir_v26i1e53740_fig1.jpg

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