MON-150 Phone Call Reminders and Mobile Health Apps: Do They Help Our Diabetic Patients?

Background: We postulate that reminders may promote lifestyle changes in Type 2 DM patients. Mobile health apps (mHA) promise behavior modification to achieve a health goal. Purpose: To create a pilot study in which phone call reminders were made to diabetics to decrease HbA1c and weight. Parallel to this, we assessed the most popular free Android lifestyle mHA. Methods: In an Ophthalmology referral practice, patients (pts) were sent by referring PCPs for diabetic eye screening. Informed consent obtained. Enrollment period 3/2018-11/2018. Inclusion criteria: Type 2 DM pts with HbA1c lab values at visit 1(V1). The second HbA1c lab test was performed within 2 months of visit 2 (V2). Ability to speak English. Exclusion criteria: Missed V2 appt. Pts were offered a weekly phone call reminder from a staff member with 4 suggestions:1) drink 2 cups of water before meals, 2) reduce carbohydrate intake by 1 serving/day, 3) eat 3 servings of raw vegetables daily, 4) exercise 20-25 minutes/day. HbA1c was collected in visit 2 (V2). Measurement of diabetic macular edema by Optical Coherence Tomography (OCT) with 250 um as normal at V1, V2. Control group of diabetic pts were monitored without weekly phone calls but were given the same 4 suggestions during V1,V2. At V2, we asked them about weight gain or weight loss, requiring a yes/no response. For the mHA analysis, Inclusion criteria: most downloads, free, mHA listed on Google Play Store in 2018. Results: Phone Group (PG) avg age=63.8 yrs, sd=9.52. Control Group (C) avg age=61.7yrs, sd=7.32. PG: n=10 pts(6M:4F) (V1):HbA1c (avg 8.64 sd 2.78, range 5.8 - 13.1) and (V2):HbA1c (avg 7.28 sd 1.27, range 6 - 9.6). For PG:avg decrease in HbA1c between visits V1&V2: 1.36 ( formula) (V2-V1) / V1=15.74 % change). C: n=10 pts(5M:5F) : (V1): HbA1c (avg 8.27 sd 2.92 range 6-11.9), (V2): HbA1c(avg 7.55, sd 2.64, range 6.2 - 15). For C: the average decrease in HbA1c between V1&V2= 0.72 (8.71% change). In both groups, 6/10 pts reported weight loss by V2. The change in macular edema measurements by OCT for both groups between V1&V2 was less than 2%. The most popular mHA by downloads: 1) MyFitnessPal (50x10^6); 2) 30 Day Fitness Challenge (10x10^6); 3) Lose It (10x10^6); 4) Lose BellyFat in 30 days (10x10^6); 5) Lose weight in 30 days (10x10^6); 6) My Diet Coach (10x10^6); 7) Better Me: Weight Loss Workouts (5x10^6); 8) Monitor Your Weight (5x10^6); 9) Weight Loss Tracker, BMI (5x10^6); 10) HealthMate (1x10^6). 10/10 had weight loss goals. 2/10 had push notification for reminders. 4/10 had rewards or congratulations for positive feedback. Conclusions: In this small pilot study, staff phone calls may have contributed to a larger change in HbA1c outcome in the Phone Call group vs Control group. Currently, mobile health apps lack systematic reminders or rewards for goal achievement. Despite the popularity of mobile health apps, a simple phone call may still make a difference.