Lessened decline in physical activity and impairment of older adults with diabetes with telemedicine and pedometer use: results from the IDEATel study.
Lessened decline in physical activity and impairment of older adults with diabetes with telemedicine and pedometer use: results from the IDEATel study.
复制标题
通过远程医疗和计步器的使用，减少了老年糖尿病患者的体力活动下降和损伤：IDEATel 研究的结果。
作者：
R. Weinstock;G. Brooks;W. Palmas;P. Morin;J. Teresi;J. Eimicke;Stephanie Silver;R. Izquierdo;R. Goland;S. Shea
目的
研究糖尿病教育和远程医疗信息学（IDEATel）远程医疗干预和计步器使用对老年糖尿病患者体力活动（PA）和损伤的影响。
设计
随机临床试验。受试者种族多样，医疗服务不足的医疗保险受益人与糖尿病（n= 1，650）。
方法
参与者每4-6周接受糖尿病教育者的家庭视频访问或常规护理。所有人都收到了一个计步器。年度测量包括血红蛋白A1 c、日常生活活动综合评估和转诊评估、糖尿病自我护理活动、Charlson Comorbid指数、Luben社会支持和计步器使用。使用随机效应进行混合模型分析，以调整初级保健医生内的聚类。
结果
与常规护理组相比，远程医疗组的PA（P= 0.0128）和身体损伤（PI）（P= 0.0370）下降率随时间推移显著降低。观察到PA的显著平均终点差异（P= 0.003）。使用计步器与PA（P= 0.0006）和PI（P< 0.0001）显著相关。与PA较高相关的基线特征包括较少的共病（P= 0.0054），较少的抑郁（P< 0.0001），更多的社交网络（P<0.0001），较低的BMI（P<0.0001），男性（P< 0.0001）和较低的血红蛋白A1 c水平（P= 0.0045）。PI的预测因子相似，除了糖尿病病程也可预测PI受损增加（P< 0.0001）。通过使用计步器观察到显著的间接效应，其减少了PA（P= 0.0024，0.0013）和PI（P= 0.0024，P< 0.0001）的下降。
结论
这种远程医疗干预降低了老年糖尿病患者的PA下降率和损害率。计步器可能是一个有用的廉价辅助糖尿病倡议提供远程与新兴技术。ClinicalTrials.gov标识符NCT 00271739。
OBJECTIVE
to examine the effects of the Informatics for Diabetes Education and Telemedicine (IDEATel) telemedicine intervention and pedometer use on physical activity (PA) and impairment in older adults with diabetes.
DESIGN
randomised clinical trial. Subjects ethnically diverse medically underserved Medicare beneficiaries with diabetes (n= 1,650).
METHODS
participants received home videovisits with a diabetes educator every 4-6 weeks or usual care. All received a pedometer. Annual measurements included hemoglobin A1c, Comprehensive Assessment and Referral Evaluation Activities of Daily Living, Diabetes Self-Care Activities, Charlson Comorbidity Index, Luben Social Support and pedometer use. Mixed model analyses were performed using random effects to adjust for clustering within primary care physicians.
RESULTS
in the telemedicine group compared with the usual care group, the rate of decline in PA (P= 0.0128) and physical impairment (PI) (P= 0.0370) was significantly less over time. Significant mean endpoint differences were observed for PA (P= 0.003). Pedometer use was significantly associated with PA (P= 0.0006) and PI (P< 0.0001). Baseline characteristics associated with greater PA included having fewer comorbid conditions (P= 0.0054), less depression (P< 0.0001), more social networking (P< 0.0001), lower BMI (P< 0.0001), male gender (P< 0.0001) and lower hemoglobin A1c level (P= 0.0045). Similar predictors were observed for PI, except duration of diabetes also predicted increased impairment (P< 0.0001). Significant indirect effects were observed through use of the pedometer on reduced decline in PA (P= 0.0024, 0.0013) and PI (P= 0.0024, P< 0.0001).
CONCLUSIONS
this telemedicine intervention reduced rates of decline in PA and impairment in older adults with diabetes. Pedometers may be a helpful inexpensive adjunct to diabetes initiatives delivered remotely with emerging technologies. ClinicalTrials.gov identifier NCT 00271739.
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DOI：
10.1093/geronj/39.2.166
发表时间：
1984-01-01
期刊：
JOURNALS OF GERONTOLOGY
影响因子：
--
作者：
GURLAND, B;GOLDEN, RR;CHALLOP, J
通讯作者：
CHALLOP, J
影响因子：
9.8
作者：
Araiza, Paul;Hewes, Hilary;Burge, Mark R.
通讯作者：
Burge, Mark R.
为综合评估和推荐评估面试时间表开发的指标量表的并发和预测有效性。
DOI：
10.1093/geronj/39.2.158
发表时间：
1984
期刊：
Journal of gerontology
影响因子：
--
作者：
Teresi,JA;Golden,RR;Gurland,BJ
通讯作者：
Gurland,BJ
影响因子：
7
作者：
MacKinnon, DP;Lockwood, CM;Sheets, V
通讯作者：
Sheets, V