BACKGROUND: Although interactive voice response (IVR) calls can be an effective tool for chronic disease management, many regions of the world lack the infrastructure to provide these services. PURPOSE: This study evaluated the feasibility and potential impact of an IVR program using a cloud-computing model to improve diabetes management in Honduras. METHODS: A single-group, pre-post study was conducted between June and August 2010. The telecommunications infrastructure was maintained on a U.S. server, and calls were directed to patients' cell phones using VoIP. Eighty-five diabetes patients in Honduras received weekly IVR disease management calls for 6 weeks, with automated follow-up e-mails to clinicians, and voicemail reports to family caregivers. Patients completed interviews at enrollment and a 6-week follow-up. Other measures included patients' glycemic control (HbA1c) and data from the IVR calling system. RESULTS: A total of 53% of participants completed at least half of their IVR calls and 23% of participants completed 80% or more. Higher baseline blood pressures, greater diabetes burden, greater distance from the clinic, and better medication adherence were related to higher call completion rates. Nearly all participants (98%) reported that because of the program, they improved in aspects of diabetes management such as glycemic control (56%) or foot care (89%). Mean HbA1c's decreased from 10.0% at baseline to 8.9% at follow-up (p<0.01). Most participants (92%) said that if the service were available in their clinic they would use it again. CONCLUSIONS: Cloud computing is a feasible strategy for providing IVR services globally. IVR self-care support may improve self-care and glycemic control for patients in underdeveloped countries. Published by Elsevier Inc.
BACKGROUND: Although interactive voice response (IVR) calls can be an effective tool for chronic disease management, many regions of the world lack the infrastructure to provide these services. PURPOSE: This study evaluated the feasibility and potential impact of an IVR program using a cloud-computing model to improve diabetes management in Honduras. METHODS: A single-group, pre-post study was conducted between June and August 2010. The telecommunications infrastructure was maintained on a U.S. server, and calls were directed to patients' cell phones using VoIP. Eighty-five diabetespatients in Honduras received weekly IVR disease management calls for 6 weeks, with automated follow-up e-mails to clinicians, and voicemail reports to family caregivers. Patients completed interviews at enrollment and a 6-week follow-up. Other measures included patients' glycemic control (HbA1c) and data from the IVR calling system. RESULTS: A total of 53% of participants completed at least half of their IVR calls and 23% of participants completed 80% or more. Higher baseline blood pressures, greater diabetes burden, greater distance from the clinic, and better medication adherence were related to higher call completion rates. Nearly all participants (98%) reported that because of the program, they improved in aspects of diabetes management such as glycemic control (56%) or foot care (89%). Mean HbA1c's decreased from 10.0% at baseline to 8.9% at follow-up (p<0.01). Most participants (92%) said that if the service were available in their clinic they would use it again. CONCLUSIONS: Cloud computing is a feasible strategy for providing IVR services globally. IVR self-care support may improve self-care and glycemic control for patients in underdeveloped countries. Published by Elsevier Inc.
Authors: Gonzalo Fernández-Cardeñosa; Isabel de la Torre-Díez; Miguel López-Coronado; Joel J P C Rodrigues Journal: J Med Syst Date: 2012-04-11 Impact factor: 4.460
Authors: John D Piette; K C Lun; Lincoln A Moura; Hamish S F Fraser; Patricia N Mechael; John Powell; Shariq R Khoja Journal: Bull World Health Organ Date: 2012-05-01 Impact factor: 9.408
Authors: John D Piette; Ann-Marie Rosland; Nicolle S Marinec; Dana Striplin; Steven J Bernstein; Maria J Silveira Journal: Med Care Date: 2013-03 Impact factor: 2.983
Authors: John D Piette; Hema Datwani; Sofia Gaudioso; Stephanie M Foster; Joslyn Westphal; William Perry; Joel Rodríguez-Saldaña; Milton O Mendoza-Avelares; Nicolle Marinec Journal: Telemed J E Health Date: 2012-10 Impact factor: 3.536