Education and Decision Support

Two main aspects are important when trying to meet patients’ needs and to support self-management by means of ICT:

  1.  the necessity to involve patients in the design of the interventions, and
  2. the importance of embedding the technological intervention into the primary care system.

The personalized approach has already proven to be successful in Lorig’s works. All the programs for chronic conditions she developed with her team were “built on needs assessments that identified patient-perceived disease-related problems” [Lorig 2006, p. 965].  The necessity to focus on patients and involve them in the intervention’s design is also crucial for Verhoeven [Verhoeven 2010] who assessed that there is a need of “better tailored” applications’ to patients’ needs. Targeting their needs does not only mean to make them part of the process, but also to account for differences in the population.

On the other hand, diabetes self-management interventions by means of technology, which aim at facilitating patients everyday life, should account for an integration of technologies into the primary care activities. Patients would need to have follow-up and constant monitoring in order to become properly empowered [Glasgow 2012]. Interactive technologies are a potential resource to improve the effectiveness of diabetes management programs. So far web-based interventions or technology enhanced interventions have shown to be useful in reducing HbA1c levels and hospitalization rates, as well as in increasing self-efficacy, diabetes knowledge, and communication between patients and health care providers.

Some practical implications and suggestions for the development of technological interventions for diabetes self-management can be summarized into six main interconnected categories:

Start from an accurate observation of the studies in the literature: identify the barriers and the enablers of self-management in order to design proper interventions and to identify “potential solutions”

  1. Tailor technologies to different populations: use technologies in a way that they can target the different types of patients
  2. Avoid the use of technology for the sake of technology but use it on the basis of a solid behavioural theory
  3. ICTs should support human contact and exchange, more specifically monitoring and follow up: foster doctor-patient communication
  4. Translate the needs of persons involved in diabetes care into a new technology: everybody should be involved in designing the intervention
  5. Pay attention to content, and not just try to develop self-management strategies but to have an holistic approach