Abstract
Background Rapidly growing numbers of Type 2 Diabetics (T2D) in the US continues to escalate need for evidence-based primary care interventions to reduce complications and costs. Limited time, information, and lack of revenue for chronic disease management create gaps between national guidelines and primary care for diabetes.
Methods Of the over 20,000 diabetics were identified in Geisinger EPIC® EHR, 3166 T2D with diagnosis on problem list or ICD-9 code had HgA1c>8.0%. Physician letters or emails were sent to invite them to call to Opt OUT if they did not want more information. After a 10 day period, staff called 1932 eligible T2D to invite them to a shared medical primary care visit to participate in a randomized controlled trial comparing a tailored 5-month web-based lifestyle intervention (dLifeG.com) to usual care. 166 Type 2 diabetics gave written informed consent and were randomized 1:2 to control group or intervention group. In <20 minutes with simple computer instructions, T2Ds in intervention group created password protected personalized website to set goals, view weekly lessons, and take interactive quizzes to improve diabetes knowledge and self-management. Weekly emails with lesson topics and links to the dLifeG.com were sent to intervention group participants. At end of study, control group will also have access to website intervention.
Results At midpoint, ~3/4th of the 100 T2 diabetics in intervention group were engaged [defined by the number of site page viewed (0–3090 pages), emails opened (0–100%), and quiz pages consumed (0–578)]. Mid and end of study changes in diabetes knowledge, HgA1c, Blood Pressure, and weight will be discussed.
Conclusions Web-based lifestyle interventions can be employed in primary care to engage a majority of diabetics with HgA1c>8.0 in a self-management lifestyle modification intervention. Importantly, the study also helped identify diabetics who may need additional resources and assistance with chronic disease management.
