A sample of low-income patients engaged with Omada Health’s digital diabetes prevention program (DPP), achieved weight loss but no major difference in HbA1c levels after a year of use, according to study data recently highlighted by the company.
The results — published late last year in the CDC’s Preventing Chronic Disease journal and first previewed at a 2018 public health conference — suggest an alternative approach to diabetes prevention for a population that more often has difficulty accessing in-person health services.
“The Omada program lowers the barriers to access, and ultimately increases preventive health engagement among any population,” Omada Director of Clinical Research Cynthia Castro Sweet, who was also an author on the paper alongside researchers from the University of Southern California, Los Angeles, said in a statement. “Our program was developed to serve the needs of participants from all backgrounds, and all walks of life. The results of this trial dispels the myth that people with economic or educational disadvantages can’t or won’t use technology to engage in their health care.”
From the 227 participants recruited and evaluated at baseline, 111 completed a follow-up roughly around the half-year mark (T1), 104 completed a roughly 12-month follow-up (T2) and 76 completed both follow-ups. One hundred and nine participants who completed the T1 follow-up were also matched to an unenrolled control patient using de-identified records.
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At baseline, 81.3% of the participants were women, 51.5% identified as Hispanic/Latino and 43% had limited proficiency in English. The average age was 48.2 years. All groups and subgroups within the trial demonstrated similar sociodemographic variables, with the exceptions that those eventually lost to follow-up were significantly less likely to have Medicaid at T1 and T2, and more likely to be working full-time at T1.
At the first and second check-in, 41% and 37% of reporting participants, respectively, had lost more than 5% of their weight. The average loss was significant at both check-ins, with mean weight loss reported as 4.2% at T1 and 4.4% at T2. Similarly, mean BMI also dropped significantly by −1.5 from baseline at T1, and −1.6 at T2.
At both check-ins, completion of nine or more lessons was significantly associated with increased weight loss. HbA1c levels mostly remained stagnant, however, with roughly similar proportions of participants falling within a prediabetic range. The only decline came at the T1 check-in (but not the T2 check-in) among participants who lost more than 5% of their baseline weight.
HOW IT WAS DONE
Between February 2016 and March 2017, researchers recruited adults enrolled in Medicaid or another safety-net insurance plan who had evidence of prediabetes within their EHR.
These participants were enrolled in Omada’s digital DPP, which includes virtual group support, lessons, personalized support from a live health coach and other tools to track their progress. It was modified for the study’s low-income target population by reducing the reading level of the curriculum, introducing Spanish translation and cultural components, and by featuring bilingual and bicultural coaches.
The researchers recorded patient outcomes of interest at baseline, at 24 to 35 weeks (T1) and at 47 to 65 weeks (T2). Controls were generated by searching de-identified EHRs with an algorithm that sought cases of a similar age and sex within 12 months prior to the beginning of enrollment.
THE LARGER PICTURE
Omada isn’t the only digital diabetes program maker in town. Solera Health and Livongo both offer a variety of tech-driven programs aimed at managing or preventing diabetes, while Virta Health often boasts of its product’s ability to reverse Type 2 diabetes.
But digital DPPs are just one of Omada’s offerings, which include hypertension management, mental health support and other chronic disease products. The company raked in $73 million in funding last summer, which it said at the time would help scale its digital care program efforts.
ON THE RECORD
“This study demonstrates that Omada achieves real outcomes with this difficult-to-reach population,” Omada Health CEO Sean Duffy said in a statement. “Digital health tools should be offered to all populations, especially when sufficient evidence shows that they can be as effective as in-person programs. By making virtual alternatives less accessible, we deny low-income patients an opportunity to lead healthier, more productive lives.”
Source: MobiHealth News