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CompletedNCT02049359SAMIUpdated Jul 3, 2023Results posted

Short Messaging Service for Optimizing Hemoglobin A1C Management in Low-Income Diabetics

An interventional study of Texting in Diabetes, sponsored by Campbell University, Incorporated. Completed at 3 sites in United States. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2023-07-03.

Sponsored by Campbell University, Incorporated · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
170
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

The purpose of this study is to determine the impact of two-way short message service (SMS) on glycemic control in low-income, poorly-controlled adult diabetic patients.

Read the detailed description

This multi-center, unblinded, prospective randomized controlled trial will enroll adult diabetic patients of the Wilson Community Health Center, Harvest Family Health Center, and Freedom Hill Community Health Center living below 200% of 2013 poverty level with a serum hemoglobin A1C >9% and who currently own a mobile device with text messaging capacity. After written informed consent has been obtained, subjects will be randomized to intervention or control group (1:1), stratified based on insulin initiation within 1 week of study inclusion. Participants randomized to the intervention group will be further divided into subgroups as "insulin user" or "non-insulin user" and both will receive SMS messages every 7 days. The content of the message consist of medication reminders, reporting of blood glucose results, insulin technique assessment (if applicable), or d) medication adherence assessment. Participants will be asked to respond with a simple text within 7 days. The intervention group will receive the standard medical appointment reminder via telephone one to two business days prior to the appointment at the Health Center PLUS a unidirectional text message two business days prior to scheduled health center appointments. Control group participants will receive the standard medical appointment reminder via telephone one to two business days prior to the appointment at the health center. All participants in the study (control and intervention) will undergo venipuncture at 3 months (+/-) 2 weeks for the determination of hemoglobin A1C. Demographic information, and frequency of hemoglobin A1C concentrations in the past 6 months will be assessed at baseline. Each week for 12 weeks, the number of texts sent per week and by type, percent of respondents weekly by text or by phone, content of participant responses, number of patients unable to be reached via text, total investigator time spent per week, and time spent per contact will be recorded. At the three month visit, the hemoglobin A1C concentration, blood transfusions since study initiation, and medication changes will be recorded.

02

Conditions studied

  • Diabetes

Keywords

  • Diabetes
03

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • New or existing patient of Carolina Family Health Centers Inc. (Wilson Community Health Center, Harvest Family Health Center, Freedom Hill Community Health Center)
  • Diagnosis of diabetes
  • Single serum hemoglobin A1C equal to or greater than 9% within 2 weeks of study enrollment
  • Below 200% of 2013 poverty level
  • Currently own a mobile device with text messaging capacity and anticipated service for duration of 12 week study period

Exclusion criteria

Exclusion Criteria:

  • Anemia diagnosed within past 3 months
  • Blood transfusion within the past 3 months
  • unable to read English at the fifth grade level
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
170 participants (actual)

Study arms

  • No intervention
    Control group

    Care as usual; no bidirectional texting

  • Experimental
    Texting

    Bidirectional texting weekly for 12 weeks

    Other: Texting

Interventions

  • OtherTexting

    Bidirectional texting once weekly for 12 weeks

05

What researchers measure

Primary outcomes

  1. Change From Baseline A1C

    Change in A1C from baseline

    Time frame: 12 weeks

Secondary outcomes

  1. Change in A1C Based on Age, Gender, Race, Type and Duration of Diabetes

    Change in A1C from baseline based on age, gender, race, type and duration of diabetes

    Time frame: 12 weeks

06

Results

Posted Jul 3, 2023

Participant flow

Participant flow — Overall Study
MilestoneControl GroupTexting
Started9575
Completed6956
Not completed2619
Withdrew: Lost to follow-up2619

Outcome measures

PrimaryChange From Baseline A1C

Change in A1C from baseline

Time frame:
12 weeks
Reported as:
Mean · percentage of A1C decrease
Change From Baseline A1C
percentage of A1C decreaseControl GroupTexting
Change From Baseline A1C1.1 (0.6 to 1.6)1.4 (0.9 to 1.8)
SecondaryChange in A1C Based on Age, Gender, Race, Type and Duration of Diabetes

Change in A1C from baseline based on age, gender, race, type and duration of diabetes

Time frame:
12 weeks
Reported as:
Mean · percentage of A1C decrease
Change in A1C Based on Age, Gender, Race, Type and Duration of Diabetes
percentage of A1C decreaseControl GroupTexting
Age 18-352.1 (0.3 to 4.0)1.9 (0.5 to 2.0)
36-55 years1.2 (0.5 to 1.8)1.4 (0.8 to 2.1)
56-65 years0.5 (0.2 to 1.2)1.5 (0.5 to 2.6)
>65 years0.8 (0.33 to 1.9)1.2 (0.2 to 2.2)
African American1.2 (0.5 to 1.7)1.3 (0.7 to 1.8)
Caucasian1.0 (0.2 to 1.7)1.4 (0.8 to 2.0)
Hispanic2.0 (NA to NA)0.9 (NA to NA)
Other1.0 (NA to NA)3.0 (NA to NA)
Female0.9 (0.3 to 1.4)1.3 (0.8 to 1.7)
Male1.4 (0.6 to 2.4)1.5 (0.7 to 2.4)

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Control Group—0/95 (0%)0/95 (0%)
Texting—0/75 (0%)0/75 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Control GroupTextingTotal
<=18 years000
Between 18 and 65 years6551116
>=65 years459
Age, Continuous
Age, Continuous(years)Control GroupTextingTotal
Mean50.4 ± 9.752.5 ± 10.351.3 ± 10.0
Sex: Female, Male
Sex: Female, Male(Participants)Control GroupTextingTotal
Female413273
Male282452
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Control GroupTextingTotal
African American504292
Caucasian151025
Hispanic213
Other235
Region of Enrollment
Region of Enrollment(Participants)Control GroupTextingTotal
United States6956125
07

Study locations

3 sites
  • Harvest Family Health Center
    Elm City, North Carolina 27822, United States
  • Freedom Hill Community Health Center
    Tarboro, North Carolina 27886, United States
  • Wilson Community Health Center
    Wilson, North Carolina 27893, United States
08

Registry details

Key details

Study ID
NCT02049359
Lead sponsor
Campbell University, Incorporated
Responsible party
Sponsor
First posted
Jan 30, 2014
Start date
Jan 2014
Primary completion
Mar 2016
Completion
Mar 2016
Results posted
Jul 3, 2023
Last update
Jul 3, 2023

Study contacts

Jennifer D Smith, PharmD
principal investigator · Campbell University/Wilson Community Health Center
Richard Drew, PharmD
study director · Campbell University/Duke University

Oversight

Data monitoring committee
No
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