Text messaging to enhance patient engagement in diabetes self-care

Abstract

Diabetes is a costly chronic condition that can lead to serious complications including kidney disease, cardiovascular disease, and vision problems. The progression of diabetes and the development of complications depends largely on the patient’s self-management behaviors. Providers often do not have enough time to teach patients all the necessary skills needed to manage this chronic disease. Diabetes self-management education (DSME) programs have been created to improve self-care activities such as healthy eating, physical activity, glucose monitoring, and medication taking. However, few patients with diabetes engage in DSME programs. Mobile health interventions have emerged as a promising tool for managing chronic conditions. Text messaging can begin to address barriers to DSME participation and engage patients in self-care behaviors in their everyday life. This quality improvement project assessed the impact of text messaging on patient attendance, satisfaction, follow-up rates, and self-management behaviors for adults with type 2 diabetes enrolled in a five week diabetes education program at the Adventist Health Castle Wellness & Lifestyle Medicine Center in Kailua, Hawaii. Attendance rates in 2019 increased compared to 2018 for two group education classes that were offered text messaging. It was not possible to determine the impact of texting on patient satisfaction or self-management behaviors due to lack of participation in post-intervention surveys. However, responses to interactive questions provided insights into the self-management strengths and weaknesses of participants. As mobile health use expands, this project is valuable as it provides a framework for future projects to further explore text messaging in diabetes education and support.