scholarly journals Validation of a Virtual Assistant for Improving Medication Adherence in Patients with Comorbid Type 2 Diabetes Mellitus and Depressive Disorder

Author(s):  
Surya Roca ◽  
María Luisa Lozano ◽  
José García ◽  
Álvaro Alesanco

Virtual assistants are programs that interact with users through text or voice messages simulating a human-based conversation. The development of healthcare virtual assistants that use messaging platforms is rapidly increasing. Still, there is a lack of validation of these assistants. In particular, this work aimed to validate the effectiveness of a healthcare virtual assistant, integrated within messaging platforms, with the aim of improving medication adherence in patients with comorbid type 2 diabetes mellitus and depressive disorder. For this purpose, a nine-month pilot study was designed and subsequently conducted. The virtual assistant reminds patients about their medication and provides healthcare professionals with the ability to monitor their patients. We analyzed the medication possession ratio (MPR), measured the level of glycosylated hemoglobin (HbA1c), and obtained the patient health questionnaire (PHQ-9) score in the patients before and after the study. We also conducted interviews with all participants. A total of thirteen patients and five nurses used and evaluated the proposed virtual assistant using the messaging platform Signal. Results showed that on average, the medication adherence improved. In the final interview, 69% of the patients agreed with the idea of continuing to use the virtual assistant after the study.

Author(s):  
Mafooza Rashid ◽  
B. K. Gupta, Vinay Bharat ◽  
Abhishek Gupta ◽  
Zubair Rashid

Background: The aim of the study was to compare the hemoglobin levels among normal controls (patients) and patients of TypeII diabetes with HbA1c levels below 7 % & above 7 %.and secondly to identify the undetected cases of anemia in TypeII diabetes. Materials & Methods - 50 patients of type 2 diabetes mellitus with their glycosylated hemoglobin levels less than 7 %, 50 patients of type 2 diabetes mellitus with their glycosylated hemoglobin levels more than 7 % attending the Medicine outpatient department of Subharti Medical College and Hospital will be the subjects for the study.50 age and sex matched controls will be selected randomly from Subharti Medical College and Hospital. Informed written consent will be taken from all the subjects. The study will be conducted from January 2016 to January. Result - We studied 50 cases with HbA1C>7(poor control),50 cases with HbA1C 5.6 to7 (good control) and 50 controls with HbA1C ≤5.6, we observed in cases with HbA1C>7 (poorly control) ,the mean HbA1C is 9.9±2 and mean Hb is 9.8±1.3 as compared to cases with HbA1C 5.6 to 7(good control) where mean HbA1C is 6±0.4 and Hb is 13±0.5,this clearly indicates that in cases HbA1C is more Hb levels are low and when HbA1C is less Hb levels are higher. Conclusion - In the present study we found negative correlation between HbA1c & Hb levels. As the value of HbA1c increases, as in cases of HbA1c >7(poor diabetic control), we found low Hb levels as compared to the cases with HbA1c <7(5.6-7) (good control).


2013 ◽  
Vol 29 (10) ◽  
pp. 1275-1286 ◽  
Author(s):  
Suellen M. Curkendall ◽  
Nina Thomas ◽  
Kelly F. Bell ◽  
Paul L. Juneau ◽  
Audrey J. Weiss

2014 ◽  
Vol 58 (4) ◽  
pp. 369-376 ◽  
Author(s):  
Joelma Ines Tagliapietra Barros ◽  
Francisco Vagnaldo Fechine ◽  
Renan Magalhães Montenegro Júnior ◽  
Otoni Cardoso do Vale ◽  
Virgínia Oliveira Fernandes ◽  
...  

Objective: To evaluate the effect of sitagliptin on somatosensory-evoked potentials (SEPs) and metabolic control in patients with type 2 diabetes mellitus without clinical diabetic neuropathy. Materials and methods: Interventional, prospective, and open study. Patients with less than six months from the diagnosis were included. Examinations of SEPs and laboratory tests at fasting and after food stimulation were performed before and after three months of treatment with sitagliptin (100 mg/day). Results: There was a reduction in the mean levels of HbA1c (P < 0.0001), fasting glucose (P = 0.001), total cholesterol (P = 0.019), and ALT (P = 0.022). An increase in active GLP-1 was found at the end of the study (P = 0.0025). Several SEPs showed statistically significant differences when analyzed before and after treatment with sitagliptin. Conclusion: The results give a glimpse of the possible use of sitagliptin in the treatment of some neurodegenerative conditions of the peripheral nervous system, in addition to its already established role in glycemic control.


2008 ◽  
Vol 93 (10) ◽  
pp. 3703-3716 ◽  
Author(s):  
Chee W. Chia ◽  
Josephine M. Egan

Context: Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide are incretins secreted from enteroendocrine cells postprandially in part to regulate glucose homeostasis. Dysregulation of these hormones is evident in type 2 diabetes mellitus (T2DM). Two new drugs, exenatide (GLP-1 mimetic) and sitagliptin [dipeptidyl peptidase (DPP) 4 inhibitor], have been approved by regulatory agencies for treating T2DM. Liraglutide (GLP-1 mimetic) and vildagliptin (DPP 4 inhibitor) are expected to arrive on the market soon. Evidence Acquisition: The background of incretin-based therapy and selected clinical trials of these four drugs are reviewed. A MEDLINE search was conducted for published articles using the key words incretin, glucose-dependent insulinotropic polypeptide, GLP-1, exendin-4, exenatide, DPP 4, liraglutide, sitagliptin, and vildagliptin. Evidence Synthesis: Exenatide and liraglutide are injection based. Three-year follow-up data on exenatide showed a sustained weight loss and glycosylated hemoglobin (HbA1c) reduction of 1%. Nausea and vomiting are common. Results from phase 3 studies are pending on liraglutide. Sitagliptin and vildagliptin are orally active. In 24-wk studies, sitagliptin reduces HbA1c by 0.6–0.8% as monotherapy, 1.8% as initial combination therapy with metformin, and 0.7% as add-on therapy to metformin. Vildagliptin monotherapy lowered HbA1c by 1.0–1.4% after 24 wk. Their major side effects are urinary tract and nasopharyngeal infections and headaches. Exenatide and liraglutide cause weight loss, whereas sitagliptin and vildagliptin do not. Conclusions: The availability of GLP-1 mimetics and DPP 4 inhibitors has increased our armamentarium for treating T2DM. Unresolved issues such as the effects of GLP-1 mimetics and DPP 4 inhibitors on β-cell mass, the mechanism by which GLP-1 mimetics lowers glucagon levels, and exactly how DPP 4 inhibitors lead to a decline in plasma glucose levels without an increase in insulin secretion, need further research.


Author(s):  
Wirawan Adikusuma ◽  
Nurul Qiyaam

  Objective: Examines the effects of counseling and short messages service (SMS) as a reminder and motivation toward medication adherence improvement and controlled HbA1c levels of type 2 diabetes mellitus (T2DM) patients.Methods: This study used a quasi-experimental method with prospective data retrieval. The subjects of this study were 40 patients with outpatient T2DM in internal disease polyclinic in West Nusa Tenggara Hospital, Indonesia. Patients who fulfilled the inclusion criteria were divided into two groups: The control group (n=20) receiving only the drug care service and the treatment group (n=20) receiving counseling and SMS reminder and motivation from the pharmacist. Data collecting was conducted using the pill count method, and HbA1c levels were taken from the medical record.Results: The results showed that counseling and SMS as reminder and motivation by a pharmacist can improve treatment adherence significantly (p<0.05) by 11.33 ± 8.47 and can decrease HbA1c level significantly (p<0.05) of 1.32 ± 0.72 in the intervention group. There was a positive correlation between T2DM patient treatment adherence to HbA1c levels (r=0.254, p=0.023).Conclusion: The provision of counseling and SMS as a reminder and motivation by the pharmacist can have a positive effect toward medication adherence and control of HbA1c in T2DM patients. 


2008 ◽  
Vol 47 (1) ◽  
pp. 144-146 ◽  
Author(s):  
Gino G. Fernandini‐Paredes ◽  
Edward Mezones‐Holguin ◽  
Rolando Vargas‐Gonzales ◽  
Eugenio Pozo‐Briceño ◽  
Alfonso J. Rodriguez‐Morales

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