Technology for low adherence: yes or no?

Abstract

In recent years, the paradigm shift in the digital era has rotated from Physician-Centered Care and patient compliance using a glucometer and based on the leading role of Glycosylated Hb to Care Centered on the Empowerment of the Person with diabetes with Multiple Interoperable Devices towards achieving good Time-in-Range. Technology as a contribution to the treatment of diabetes has been shown to improve quality of life and impact glycemic control with a decrease in acute complications.

Fred Davis proposed the Technology Acceptance Model (TAM) in 1989, suggesting that there are a number of factors that influence the decision to use a technology. Among these factors, the perceived usefulness and the perceived ease stand out, which generates the attitude of acceptance or discontinuation of it.

Several publications have shown that the challenges in achieving adherence to technology are the management of Body Image (76% of people with diabetes 1 suffer from stigmatization due to the disease), Education in the analysis of Data download, evaluating the overload, infotoxicity, Frustration and Confidence in the result, and the burnout of the data provided, which must be counteracted by access to a Structured Educational program provided by an Interdisciplinary Team. The acquisition of skills and abilities are addressing the complexity of transforming data into information for the achievement of decision making. The adoption of innovative strategies such as the use of ICTs or apps imply cost-effectiveness benefits and optimizes the self-management of the disease, impacts behavior changes, improving biological results and psychosocial aspects, becoming a good ally to promote healthy habits.

Continuous monitoring is a very robust component of therapeutic education and adherence can be assessed with use greater than 70% of the time, number of readings (ideal average greater than 10 per day) and at least one reading every 8 hours in the case of intermittent monitoring.

Well-indicated technology developed in equity can be an opportunity to educate, motivate, have an impact in the future and reduce the burden of disease.