Potential Impact of a Smartphone Lifestyle App Intervention on Therapeutic Decisions in the Prevention and Treatment of Metabolic Disease in the VA Healthcare System

Abstract

Specific Aims: To identify clinical decision parameters required to gain support on the implementation of a lifestyle intervention app from the perspective of multiple types of providers. To determine if a there are groups of providers more likely to use the lifestyle modification app based upon metabolic markers seen in current BeWell24 App. To identify barriers to implementation of the lifestyle app in the VA PACT model. Methods: Questionnaires administered via secured encryption email as well as physical paper handouts distributed at PACT team huddles and meetings or individually arranged times. Providers rated the importance of the following parameters on their therapeutic decisions: change in hemoglobin A1C, fasting blood glucose, waist circumference, blood pressure, triglycerides, and HDL as well as answer qualitative questions on the practical implementation of the BeWell24 Lifestyle App. Main Results: The subjects were current Phoenix VA employees including physicians, pharmacists, nurse practitioners, physician assistants and nutritionists. Providers expected reductions as follows: A1c 0.5-0.9%, 20-29 mg/dL Fasting Blood Glucose, weight 12-15 kg, systolic blood pressure 7-10 mmHg and Triglycerides11-15%. Each discipline had similar expectations of what improvements patients should show intervention, no statistical significance between groups (p = 0.993). Providers identified barriers to implementation including time and technology on both the patient and provider use. Conclusions: VA providers of various types had similar expectations on the BeWell24 app as it relates to patient reduction in metabolic risk factors and were able to provide valuable feedback to implementation of the lifestyle intervention into the VA system.