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| Name | Class |
|---|---|
| SingHealth Polyclinics | OTHER |
| National University of Singapore | OTHER |
| Duke-NUS Graduate Medical School | OTHER |
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Chronic diseases are the leading cause of deaths in Singapore. The rising prevalence in chronic diseases with age and Singapore's rapidly aging population calls for new models of care to effectively prevent the onset and delay the progression of these diseases. Advancement in medical technology has offered new innovations that aid healthcare systems in coping with the rapid rising in healthcare needs. These include mobile applications, wearable technologies and machine learning-derived personalized behaviorial interventions. The overall goal of the project is to improve health outcomes in chronic disease patients through delivering targeted nudges via mobile application and wearable to sustain behavioral change. Our overall objective is to design, develop, and evaluate an adaptive intervention platform on wearable devices and shared decision-making during consultations for patients with diabetes and hypertension. Our aim for this study is to assess the clinical effectiveness of real-time personalized educational and behavioural interventions delivered through wearable (Fitbit) and an integrative mobile application in improving patient glycaemic control measured using HbA1c over 9 months. Secondary outcomes will include change in systolic blood pressure, quality of life (QoL), patient activation, medication adherence, physical activity level, diet, direct healthcare cost and indirect healthcare cost over 9 months. We will conduct a randomized controlled trial among patients with comorbid diabetes and hypertension. This proposal aims to develop sustainable and cost-effective behavioural change among patients with comorbid diabetes and hypertension through patient empowerment and targeted chronic disease care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental |
| |
| Control | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nudge, health coaching and shared decision-making | Behavioral | The EMPOWER app aims to nudge the participant towards successful self-management of their diabetes condition by encouraging and reinforcing positive lifestyle behaviors in 3 main aspects - diet, physical activity, medication adherence. Notifications included content based on behavioural change technique including feedback on performance, positive reinforcement, and prompts to self-monitor. Each notification focused on a single behaviour (physical activity, medication adherence or diet). The participants in the intervention group will also interact with health coach throughout the study duration. In this study, the health coach will be responsible for the following roles :
A report card summarizing the lifestyle behaviour, goals will be made available to facilitate shared decision making. |
| Measure | Description | Time Frame |
|---|---|---|
| HbA1c | HbA1c over 9 months | 9 months |
| Measure | Description | Time Frame |
|---|---|---|
| Systolic blood pressure | Systolic blood pressure over 9 months | 9 months |
| Physical activity as measured by number of steps | Physical activity over 9 months |
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Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| SingHealth Polyclinic (Bedok) | Singapore | Singapore | ||||
| SingHealth Polyclinic (Punggol) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38408067 | Derived | Kwan YH, Yoon S, Tai BC, Tan CS, Phang JK, Tan WB, Tan NC, Tan CYL, Koot D, Quah YL, Teo HH, Low LL. Empowering patients with comorbid diabetes and hypertension through a multi-component intervention of mobile app, health coaching and shared decision-making: Protocol for an effectiveness-implementation of randomised controlled trial. PLoS One. 2024 Feb 26;19(2):e0296338. doi: 10.1371/journal.pone.0296338. eCollection 2024. |
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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|
| 9 months |
| Physical activity as measured by moderate to vigorous active minutes | Physical activity over 9 months | 9 months |
| Patient activation score as measured by patient activation measure | Difference in patient activation score between intervention and control over 9 months | 9 months |
| Medication adherence as measured by Voils Scale | Difference in medication adherence between intervention and control over 9 months | 9 months |
| Quality of life as measured by EQ-5D-5L | Difference in quality of life between intervention and control over 9 months | 9 months |
| Healthcare cost | Healthcare cost over 9 months | 9 months |
| Singapore |
| Singapore |
| SingHealth Polyclinic (Tampines) | Singapore | Singapore |
| D004700 | Endocrine System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |