DIADEM: implementation of a comprehensive disease management programme for type 2 diabetes

The purpose of the study was to evaluate the feasibility and acceptance of an IT-based diabetes disease management programme. The study was performed at two test sites in Aachen (Germany) and Cardiff (UK) including 166 and 137 patients respectively. The study focused on the technical feasibility of a web-based communication platform and its acceptance among medical professionals, the patient acceptance of entering self-measured data via phone and of service-centre support, the acceptance of implementing quality management measures, and the effects of all these measures on glycaemic control. The maximum programme duration was four months at Aachen and six months at Cardiff. The main outcomes were utilisation data, and satisfaction of both patients and physicians with the different components of DIADEM. HbA1c concentrations improved significantly from 7.1±1.0% to 6.8±1.1% in Aachen and from 7.7±1.0% to 7.1±1.1% in Cardiff (each p<0.001). The platform as a hosted ASP (application service provider) solution was accessible using a standard Internet enabled PC. Following training, a fast and efficient introduction of the software to professional users was obtained. Patient acceptance was very high both in terms of utilisation of the system (13 000 data entries performed during 6800 calls) and in terms of patient satisfaction assessed by a patient survey (93% very satisfied or satisfied). Patients strongly preferred a DTMF (dual tone multi-frequency) interface entering data by telephone key-pad rather than voice recognition. This study showed that an IT-based diabetes disease management service improved glycaemic control in patients with type 2 diabetes and could find acceptance by patients and professionals if convenient pathways for data entry and transmission are provided. Copyright © 2005 John Wiley & Sons, Ltd.