Sociodemographic and clinical correlates of key outcomes from a Mobile Insulin Titration Intervention (MITI) for medically underserved patients.
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Abstract
BACKGROUND Insulin titration is typically done face to face with a clinician however this can be a burden for patients due to logistical issues associated with in person clinical care The Mobile Insulin Titration Intervention MITI used basic cell phone technology including text messages and phone calls to help patients with diabetes find their optimal basal insulin dose OID OBJECTIVE To evaluate sociodemographic and clinical correlates of reaching OID text message response rate and days needed to reach OID METHODS Primary care providers referred patients to MITI and nurses delivered the program Three multivariable regression models quantified relationships between various correlates and primary outcomes RESULTS The sample included 113 patients from 2 ambulatory clinics with a mean age of 50 years SD 10 45 female 79 Hispanic 43 unemployed and 46 uninsured In regression models baseline fasting blood glucose FBG was negatively associated with odds of reaching OID and 100 text responses and positively associated with days to reach OID p Under 05 CONCLUSIONS Patients with higher baseline FBG levels were less successful across outcomes and may need additional supports in future mHealth diabetes programs PRACTICAL IMPLICATIONS Basic cell phone technology can be used to adjust patients insulin remotely thereby reducing logistical barriers to care