Telehealth use in patients with type 2 diabetes in Australian general practice during the COVID- 19 pandemic: a retrospective cohort study
Telehealth use in patients with type 2 diabetes in Australian general practice during the COVID- 19 pandemic: a retrospective cohort study
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DOI：
10.3399/bjgpo.2021.0200
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发表时间：
2023-09-01
期刊：
影响因子：
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通讯作者：
Georgiou, Andrew
中科院分区：
文献类型：
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作者：
Imai, Chisato;Thomas, Judith;Georgiou, Andrew
背景：为应对COVID- 19大流行，澳大利亚政府于2020年3月中旬推出了临时政府补贴的远程医疗服务项目（电话和视频会议）。2型糖尿病（T2DM）患者接受远程医疗咨询全科医生的情况尚不清楚。目的：评估远程医疗咨询的接受情况和澳大利亚全科医生的相关患者特征，包括使用远程医疗时血红蛋白A1c （HbA1c）检测的频率和HbA1c水平的变化，并与指南建议进行比较。设计与设置：这项探索性研究使用了来自澳大利亚维多利亚州和新南威尔士州（NSW）约800名全科医生的电子患者数据。将2019年3月至2020年2月的covid - 19前时期与2020年3月至2021年2月的大流行时期进行了比较。2018年3月之前诊断为T2DM的患者被纳入研究。方法：对远程医疗的吸收模式进行综合和病人特征的检查。使用广义估计方程模型来检查患者6个月HbA1c检测的概率和HbA1c水平的变化，比较使用远程医疗的患者和未使用远程医疗的患者。结果：57 916例患者中，80.8%的患者在疫情期间进行了远程医疗咨询。远程医疗咨询与年龄较大、女性、患有慢性肾脏疾病（CKD）、处方抗糖尿病药物和居住在偏远地区的2型糖尿病患者呈正相关。6个月HbA1c检测和HbA1c水平在远程医疗用户和仅面对面咨询的患者之间无显著差异。结论：2型糖尿病患者远程医疗会诊效果良好。通过远程医疗进行糖尿病监测护理与面对面咨询一样有效。
Background: The Australian government introduced temporary government-subsidised telehealth service items (phone and video-conference) in mid -March 2020 in response to the COVID- 19 pandemic. The uptake of telehealth by patients with type 2 diabetes (T2DM) for consulting with GPs is unknown. Aim: To evaluate the uptake of telehealth consultations and associated patient characteristics in Australian general practice, including the frequency of haemoglobin A1c (HbA1c) tests and change in HbA1c levels by telehealth use, compared with guideline recommendations. Design & setting: This exploratory study used electronic patient data from approximately 800 general practices in Victoria and New South Wales (NSW), Australia. A pre-COVID- 19 period from March 2019-February 2020 was compared with a pandemic period from March 2020-February 2021. Patients diagnosed with T2DM before March 2018 were included. Method: Telehealth uptake patterns were examined overall and by patient characteristics. Generalised estimating equation models were used to examine patient probability of 6-monthly HbA1c testing and change in HbA1c levels, comparing between patients who did and patients who did not use telehealth. Results: Of 57 916 patients, 80.8% had telehealth consultations during the pandemic period. Telehealth consultations were positively associated with patients with T2DM who were older, female, had chronic kidney disease (CKD), prescribed antidiabetic medications, and living in remote areas. No significant difference was found in 6-monthly HbA1c testing and HbA1c levels between telehealth users and patients who had face -to -face consultations only. Conclusion: Telehealth GP consultations were well utilised by patients with T2DM. Diabetes monitoring care via telehealth is as effective as face -to -face consultations.