OBJECTIVE: To examine whether video consultations preceded by measurements of blood glucose, weight and blood pressure as add-on to standard care could contribute to achieving and maintaining good diabetes control among patients with poorly regulated type 2 diabetes (T2D). DESIGN: Randomized controlled trial. METHODS: 165 patients with T2D were randomized 1:1 to telemedicine intervention as add-on to clinic-based care or control (clinic-based care). The intervention consisted of monthly video conferences with a nurse via a tablet computer and lasted for 32 weeks. Regularly self-monitored measurements of blood sugar, blood pressure and weight were uploaded and visible to patient and nurse. Both groups were followed up six months after the end of the intervention period. PRIMARY ENDPOINT: HbA1c after eight months. RESULTS: Video conferences preceded by uploads of measurements as add-on to clinic-based care led to a significant reduction of HbA1c compared to that in standard care (0.69% vs 0.18%, P = 0.022). However, at six-month follow-up, the inter-group difference in HbA1c-reduction was no longer significant. Non-completers had higher HbA1c levels at baseline and a lower degree of education. CONCLUSION: Video consultations preceded by uploading relevant measurements can lead to clinically and statistically significant improvements in glycemic control among patients who have not responded to standard regimens. However, continuing effort and attention are essential as the effect does not persist when intervention ends. Furthermore, future studies should focus on differentiation as the most vulnerable patients are at greater risk of non-adherence.
OBJECTIVE: To examine whether video consultations preceded by measurements of blood glucose, weight and blood pressure as add-on to standard care could contribute to achieving and maintaining good diabetes control among patients with poorly regulated type 2 diabetes (T2D). DESIGN: Randomized controlled trial. METHODS: 165 patients with T2D were randomized 1:1 to telemedicine intervention as add-on to clinic-based care or control (clinic-based care). The intervention consisted of monthly video conferences with a nurse via a tablet computer and lasted for 32 weeks. Regularly self-monitored measurements of blood sugar, blood pressure and weight were uploaded and visible to patient and nurse. Both groups were followed up six months after the end of the intervention period. PRIMARY ENDPOINT: HbA1c after eight months. RESULTS: Video conferences preceded by uploads of measurements as add-on to clinic-based care led to a significant reduction of HbA1c compared to that in standard care (0.69% vs 0.18%, P = 0.022). However, at six-month follow-up, the inter-group difference in HbA1c-reduction was no longer significant. Non-completers had higher HbA1c levels at baseline and a lower degree of education. CONCLUSION: Video consultations preceded by uploading relevant measurements can lead to clinically and statistically significant improvements in glycemic control among patients who have not responded to standard regimens. However, continuing effort and attention are essential as the effect does not persist when intervention ends. Furthermore, future studies should focus on differentiation as the most vulnerable patients are at greater risk of non-adherence.
Authors: Aoife Stephenson; Sarah Howes; Paul J Murphy; Judith E Deutsch; Maria Stokes; Katy Pedlow; Suzanne M McDonough Journal: PLoS One Date: 2022-05-11 Impact factor: 3.752
Authors: Sara E Shaw; Deborah Cameron; Joseph Wherton; Lucas M Seuren; Shanti Vijayaraghavan; Satyajit Bhattacharya; Christine A'Court; Joanne Morris; Trisha Greenhalgh Journal: JMIR Res Protoc Date: 2018-07-31
Authors: Sara E Shaw; Gemma Hughes; Joseph Wherton; Lucy Moore; Rebecca Rosen; Chrysanthi Papoutsi; Alex Rushforth; Joanne Morris; Gary W Wood; Stuart Faulkner; Trisha Greenhalgh Journal: Front Digit Health Date: 2021-12-20
Authors: Sara E Shaw; Lucas Martinus Seuren; Joseph Wherton; Deborah Cameron; Christine A'Court; Shanti Vijayaraghavan; Joanne Morris; Satyajit Bhattacharya; Trisha Greenhalgh Journal: J Med Internet Res Date: 2020-05-11 Impact factor: 5.428
Authors: Judith Byaruhanga; Prince Atorkey; Matthew McLaughlin; Alison Brown; Emma Byrnes; Christine Paul; John Wiggers; Flora Tzelepis Journal: J Med Internet Res Date: 2020-09-11 Impact factor: 5.428