Case studyVernova Healthcare CIC, Eastern Cheshire

Type 2 diabetes randomised controlled trial with Healum

Healum and Vernova Healthcare CIC ran a randomised controlled trial across 15 GP practices in Eastern Cheshire. People with type 2 diabetes who had a Healum care plan and app reduced their HbA1c and rated their health higher.

A woman reads her blood glucose meter beside healthy food on her kitchen table

Results

What changed

Source: Heald AH et al., Diabetes Therapy 2023.

72.4%

of patients with a Healum care plan and app reduced their HbA1c

Usual care: 41.5%

−7.4%

average change in HbA1c over six months

Usual care: +1.8%

+8.2%

in self-rated health, measured by EQ VAS

Usual care: −2.8%

I was never really told about the things I could do myself… having the app there is a helpful reminder to do things myself to help my health.

Patient with app access · type 2 diabetes trial

What the trial set out to do

The growing number of people living with long-term conditions is one of the biggest challenges facing health and care systems. Diabetes is a large part of it:

463 million adults worldwide were living with diabetes in 2019, a figure expected to reach 700 million by 2045
90% of cases are type 2 diabetes
Over £14 billion a year is what type 2 diabetes costs the NHS

Primary care teams saw high rates of type 2 diabetes, but a gap in the self-management support they could offer between appointments. They needed a scalable way for multidisciplinary teams to give each patient a relevant plan of care and support.

Healum worked with Vernova Healthcare CIC, a GP federation, to test the Healum care planning software and patient app in a real-world randomised controlled trial. The aim: to measure the impact on health outcomes, quality of life and behaviour for people living with type 2 diabetes.

What the team did

People with type 2 diabetes and an HbA1c above 58 mmol/mol were randomly assigned to usual care, or to usual care plus a Healum care plan and app. Over six months, 103 people in the Healum group used the app.

Practice nurses and doctors created the care plans in routine appointments, after a one-hour training session. Healum’s integration with EMIS Web let them open a patient’s profile from the record, pull in the information they needed and send updates back.

Diabetes nurses and doctors in the trial were able to:

Set goals and actions with each patient, as part of shared decision making
Monitor each patient’s progress against the goals they had set
Share resources and local services that support healthy lifestyle choices
Update patients automatically with their latest test results from EMIS

Staff could tailor the resources, goals and plans they shared to each person’s cultural and socioeconomic background, to help address health inequalities.

A clinician talks with a man in a consulting room — A third of care planning appointments resulted in health objectives unique to the individual.

“The act of thinking of and capturing goals I think was really good. Before this, I didn’t feel as if anyone had asked me those questions.”

Patient with app access, type 2 diabetes trial

What changed

Health outcomes improved

Patients with a Healum care plan and app reduced their HbA1c and BMI. Over six months, average HbA1c fell 7.4% in the Healum group and rose 1.8% with usual care, a statistically significant difference.

72.4% of the Healum group reduced their HbA1c, against 41.5% with usual care
Average HbA1c fell from 70.6 to 64.1 mmol/mol, while it rose from 68.9 to 69.1 mmol/mol with usual care
52.7% of the Healum group reduced their BMI, against 42.9% with usual care
Average BMI fell 0.7% in the Healum group, against 0.2% with usual care

Quality of life improved

People with a care plan and app rated their quality of life higher after six months.

Their EQ-5D-5L score rose by 0.0464 on average, while it fell by 0.0086 with usual care
Their EQ VAS score, a self-rating of overall health, rose 8.2%, against a 2.8% fall with usual care

More use, bigger effect

People who used the app at least twice in the first month saw HbA1c fall 8.5% on average, against 1.5% for those who used it once
People who used it at least 10 times between months three and six saw the biggest fall, at 12.3%

People kept using the app

The 103 app users completed 2,078 sessions. In the first 30 days, 84% used the app at least twice and 30% used it at least 10 times.

A woman smiles at her phone, holding a mug of tea at home

Care teams motivated and educated patients

Care teams agreed and shared 280 goals in care plans, and patients completed 343 goals in the app, such as “To be healthy enough to have a safe pregnancy”.

Resources were shared 5,396 times and viewed more than 2,200 times, including recipes like “1-minute omelette”.

Staff understood their patients’ needs better

App users made 6,279 healthy choices, an average of 61 each, including more than 1,000 actions completed and more than 2,400 tracking entries.

Practice teams could see how each patient was getting on between appointments.

In their words

“Having the app has made me feel more motivated. Before, whenever I went to the GP, it was all about the drugs I must take and that was it.”

Patient with app access, type 2 diabetes trial

“A key challenge in long-term condition management is to motivate and support patients to make healthy choices and understand how to best manage their diabetes in a way that means something to them.”

Dr Adrian Heald, Chief Investigator