OBJECTIVE: Patient self-management support may be augmented by using home-based technologies that generate data points that providers can potentially use to make more timely changes in the patients' care. The purpose of this study was to evaluate the effectiveness of short-term targeted use of remote data transmission on treatment outcomes in patients with diabetes who had either out-of-range hemoglobin A1c (A1c) and/or blood pressure (BP) measurements. MATERIALS AND METHODS: A single-center randomized controlled clinical trial design compared in-home monitoring (n=55) and usual care (n=53) in patients with type 2 diabetes and hypertension being treated in primary care clinics. Primary outcomes were A1c and systolic BP after a 12-week intervention. RESULTS: There were no significant differences between the intervention and control groups on either A1c or systolic BP following the intervention. CONCLUSIONS: The addition of technology alone is unlikely to lead to improvements in outcomes. Practices need to be selective in their use of telemonitoring with patients, limiting it to patients who have motivation or a significant change in care, such as starting insulin. Attention to the need for effective and responsive clinic processes to optimize the use of the additional data is also important when implementing these types of technology.
RCT Entities:
OBJECTIVE:Patient self-management support may be augmented by using home-based technologies that generate data points that providers can potentially use to make more timely changes in the patients' care. The purpose of this study was to evaluate the effectiveness of short-term targeted use of remote data transmission on treatment outcomes in patients with diabetes who had either out-of-range hemoglobin A1c (A1c) and/or blood pressure (BP) measurements. MATERIALS AND METHODS: A single-center randomized controlled clinical trial design compared in-home monitoring (n=55) and usual care (n=53) in patients with type 2 diabetes and hypertension being treated in primary care clinics. Primary outcomes were A1c and systolic BP after a 12-week intervention. RESULTS: There were no significant differences between the intervention and control groups on either A1c or systolic BP following the intervention. CONCLUSIONS: The addition of technology alone is unlikely to lead to improvements in outcomes. Practices need to be selective in their use of telemonitoring with patients, limiting it to patients who have motivation or a significant change in care, such as starting insulin. Attention to the need for effective and responsive clinic processes to optimize the use of the additional data is also important when implementing these types of technology.
Authors: Thomas G Pickering; John E Hall; Lawrence J Appel; Bonita E Falkner; John Graves; Martha N Hill; Daniel W Jones; Theodore Kurtz; Sheldon G Sheps; Edward J Roccella Journal: Hypertension Date: 2004-12-20 Impact factor: 10.190
Authors: Judith M E Walsh; Kathryn M McDonald; Kaveh G Shojania; Vandana Sundaram; Smita Nayak; Robyn Lewis; Douglas K Owens; Mary Kane Goldstein Journal: Med Care Date: 2006-07 Impact factor: 2.983
Authors: Joshua Chodosh; Sally C Morton; Walter Mojica; Margaret Maglione; Marika J Suttorp; Lara Hilton; Shannon Rhodes; Paul Shekelle Journal: Ann Intern Med Date: 2005-09-20 Impact factor: 25.391
Authors: K R Lorig; D S Sobel; A L Stewart; B W Brown; A Bandura; P Ritter; V M Gonzalez; D D Laurent; H R Holman Journal: Med Care Date: 1999-01 Impact factor: 2.983
Authors: Bonnie J Wakefield; John E Holman; Annette Ray; Melody Scherubel; Margaret R Adams; Stephen L Hillis; Gary E Rosenthal Journal: Telemed J E Health Date: 2011-04-10 Impact factor: 3.536
Authors: Hertzel C Gerstein; Michael E Miller; Robert P Byington; David C Goff; J Thomas Bigger; John B Buse; William C Cushman; Saul Genuth; Faramarz Ismail-Beigi; Richard H Grimm; Jeffrey L Probstfield; Denise G Simons-Morton; William T Friedewald Journal: N Engl J Med Date: 2008-06-06 Impact factor: 91.245
Authors: Donna L McLean; Finlay A McAlister; Jeffery A Johnson; Kathryn M King; Mark J Makowsky; Charlotte A Jones; Ross T Tsuyuki Journal: Arch Intern Med Date: 2008-11-24
Authors: Caroline Sanders; Anne Rogers; Robert Bowen; Peter Bower; Shashivadan Hirani; Martin Cartwright; Ray Fitzpatrick; Martin Knapp; James Barlow; Jane Hendy; Theti Chrysanthaki; Martin Bardsley; Stanton P Newman Journal: BMC Health Serv Res Date: 2012-07-26 Impact factor: 2.655
Authors: Richelle J Koopman; Bonnie J Wakefield; Jennifer L Johanning; Lynn E Keplinger; Robin L Kruse; Marilee Bomar; Beth Bernt; Douglas S Wakefield; David R Mehr Journal: Telemed J E Health Date: 2013-12-18 Impact factor: 3.536
Authors: Allison A Lewinski; Connor Drake; Ryan J Shaw; George L Jackson; Hayden B Bosworth; Megan Oakes; Sarah Gonzales; Nicole E Jelesoff; Matthew J Crowley Journal: J Am Med Inform Assoc Date: 2019-07-01 Impact factor: 4.497