Endocrinology Telehealth Consultation Improved Glycemic Control Similar to Face-to-Face Visits in Veterans.
Endocrinology Telehealth Consultation Improved Glycemic Control Similar to Face-to-Face Visits in Veterans.
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DOI：
10.1177/1932296816648343
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发表时间：
2016-09-01
影响因子：
5
通讯作者：
Rasouli, Neda
中科院分区：
文献类型：
--
作者：
Liu, Winnie;Saxon, David R;Rasouli, Neda
背景技术背景：通过退伍军人健康管理局接受医疗保健的退伍军人的糖尿病发病率高于普通人群。此外，许多退伍军人生活在农村地区，远离退伍军人事务部（VA）医院，从而限制了他们随时寻求面对面糖尿病内分泌护理的能力。远程医疗（TH）技术提供了一个机会，以改善获得专业糖尿病护理，为这些患者，但是，有一个缺乏证据的能力TH，以改善血糖控制相比，传统的面对面consultation.METHODS：这是一个回顾性队列研究的所有新的内分泌糖尿病咨询在丹佛退伍军人医疗中心超过1年的时间。共有189名患者被纳入分析。共有85例患者接受了糖尿病面对面（FTF）内分泌咨询，104例患者接受了TH咨询。受试者大多为男性（94.7%），平均年龄为62.8 ± 10.1岁。1次访视后，TH组的HbA1c从9.76%（9.40%至10.11%）改善至8.55%（8.20%至8.91%）（P < .0001），FTF组从9.56%（9.16%至9.95%）改善至8.62%（8.22%至9.01%）（P < .0001）。TH组和FTF组的HbA1c变化无显著差异（P = 0.24）。TH访问与一个假设的节省中位数距离旅行231.2英里每trip（相当于节省94.79美元每trip）。结论：内分泌TH咨询改善短期血糖控制有效的传统FTF访问的退伍军人糖尿病患者。
BACKGROUND: Rates of diabetes for veterans who receive health care through the Veterans Health Administration are higher than rates in the general population. Furthermore, many veterans live in rural locations, far from Veterans Affairs (VA) hospitals, thus limiting their ability to readily seek face-to-face endocrinology care for diabetes. Telehealth (TH) technologies present an opportunity to improve access to specialty diabetes care for such patients; however, there is a lack of evidence regarding the ability of TH to improve glycemic control in comparison to traditional face-to-face consultations.METHODS: This was a retrospective cohort study of all new endocrinology diabetes consultations at the Denver VA Medical Center over a 1-year period.RESULTS: A total of 189 patients were included in the analysis. In all, 85 patients had received face-to-face (FTF) endocrinology consultation for diabetes and 104 patients had received TH consultation. Subjects were mostly males (94.7%) and the mean age was 62.8 ± 10.1 years old. HbA1c improved from 9.76% (9.40% to 10.11%) to 8.55% (8.20% to 8.91%) (P < .0001) for the TH group and from 9.56% (9.16% to 9.95%) to 8.62% (8.22% to 9.01%) (P < .0001) for the FTF group after 1 visit. This change in HbA1c was not significantly different in the TH and FTF groups (P = .24). TH visits were associated with a hypothetical savings in median distance traveled of 231.2 miles per trip (which equates to $94.79 saved per trip).CONCLUSIONS: Endocrinology TH consultations improved short-term glycemic control as effectively as traditional FTF visits in a veteran population with diabetes.