Use of automated telephone disease management calls in an ethnically diverse sample of low-income patients with diabetes
Use of automated telephone disease management calls in an ethnically diverse sample of low-income patients with diabetes
复制标题
DOI：
10.2337/diacare.22.8.1302
复制
发表时间：
1999-08-01
期刊：
影响因子：
16.2
通讯作者：
Kraemer, FB
中科院分区：
文献类型：
--
作者：
Piette, JD;McPhee, SJ;Kraemer, FB
目的 - 我们检查了合法收入的糖尿病患者是否能够并且愿意使用自动电话疾病管理 (ATDM) 电话来提供健康状况信息，从而提高他们的护理质量。 研究设计和方法 - 共有 252 名成人糖尿病患者，其中 30 人以西班牙语为主要语言，在就诊时登记在退伍军人事务部医疗保健系统 (n = 132) 或县医疗保健系统 (n = 120）。患者在 12 个月内接到 A-TDM 电话并使用按键式电话回答询问。我们检查了 1) 患者是否在一年内持续完成 ATDM 评估并使用电话报告其自我监测血糖 (SMBG) 水平，2) 最有可能频繁使用该系统的患者的特征 3) 患者在 ATDM 评估中的反应是否一致，以及 4) ATDM 评估是否在基线时具有不同临床特征的患者组之间存在差异。 结果 - 所有患者中有一半完成了至少 77% 的尝试评估，四分之一完成了至少91%。一半的患者在至少 86% 的评估中报告了 SMBG 水平。患者全年持续完成评估并报告血糖水平。健康状况指标是评估完成率最重要的决定因素，而社会经济因素与患者在评估期间报告 SMBG 数据的可能性关系更为密切。患者在评估中的反应是一致的，他们在初始评估中提供的信息确定了血糖控制不佳和其他健康问题的群体。 结论 - 大多数低收入糖尿病患者可以并且将会使用 ATDM 尾巴作为其护理的一部分。他们提供的信息可靠且具有临床意义。 ATDM 呼叫可以改善糖尿病管理的信息库，同时减轻在成本限制下提供糖尿病护理的一些压力。
OBJECTIVE - We examined whether law-income patients with diabetes were able and willing to use automated telephone disease management (ATDM) calls to provide health status information that could improve the quality of their care.RESEARCH DESIGN AND METHODS - A total of 252 adults with diabetes, 30 of whom spoke Spanish as their primary language, were enrolled at the time of clinic visits in a Department of Veterans Affairs health care system (n = 132) or a county health care system (n = 120). Patients received A-TDM calls for 12 months and responded to queries using their touch-tone telephones. We examined 1) whether patients completed ATDM assessments consistently over the year and used the calls to report their self-monitored blood glucose (SMBG) levels, 2) the characteristics of patients most likely to use the system frequently 3) whether patients responded consistently within ATDM assessments, and 4) whether ATDM assessments differentiated among groups of patients with different clinical profiles at baseline.RESULTS - Half of all patients completed at least 77% of their attempted assessments, and one-fourth completed at least 91%. Half of all patients reported SMBG levels during at least 86% of their assessments. Patients completed assessments and reported glucose levels consistently over the year. Health status indicators were the most important determinants of assessment completion rates, while socioeconomic factors were more strongly associated with patients' likelihood of reporting SMBG data during assessments. Patients' responses within assessments were consistent, and the information they provided during their initial assessments identified groups with poor glycemic control and other health problems.CONCLUSIONS - Most low-income patients with diabetes can and will use ATDM tails as part of their care. The information they provide is reliable and has clinical significance. ATDM calls could improve the information base for diabetes management while relieving some of the pressures of delivering diabetes care under cost constraints.