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Effectiveness and acceptability of a text message intervention (DTEXT) on HbA1c and self-management for people with type 2 diabetes. A randomized controlled trial [with consumer summary]
Waller K, Furber S, Bauman A, Allman-Farinelli M, van den Dolder P, Hayes A, Facci F, Franco L, Webb A, Moses R, Cook R, Gugusheff J, Owen K, Colagiuri S
Patient Education and Counseling 2021 Jul;104(7):1736-1744
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Determine the effectiveness and acceptability of a text message intervention (DTEXT) on HbA1c and self-management behaviors for Australian adults with type 2 diabetes. METHODS: Using intention to treat analysis and generalized estimating equations, this randomized controlled trial of 395 adults determined change in HbA1c at 3 and 6 months between the intervention and control group. Secondary outcomes included change in nutrition, physical activity, blood lipid profile, body mass index, quality of life, self-efficacy, medication taking and program acceptability. RESULTS: No significant difference was observed between the intervention or control group for HbA1c at 3 months (p = 0.23) or 6 months (p = 0.22). Significant improvements were seen in consumption of vegetables at 3 months (p < 0.001) and 6 months (p = 0.04); fruit at 3 months (p = 0.046) and discretionary sweet foods at 3 months (p = 0.02). No other significant effects seen. The intervention demonstrated high rates of acceptability (94.0%) and minimal withdrawal (1.5%). CONCLUSIONS: DTEXT was an acceptable text message intervention that improved some nutritional behaviors in people with type 2 diabetes, but did not significantly improve HbA1c or other outcomes. Further research is required to optimize DTEXT. PRACTICE IMPLICATIONS: DTEXT provides an acceptable, feasible form of self-management support that may complement existing diabetes care.
With permission from Excerpta Medica Inc.

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