The Impact of Telehome Care on Health Status and Quality of Life Among Patients with Diabetes in a Primary Care Setting in Poland
The Impact of Telehome Care on Health Status and Quality of Life Among Patients with Diabetes in a Primary Care Setting in Poland
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DOI：
10.1089/tmj.2010.0113
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发表时间：
2011-04-01
影响因子：
4.7
通讯作者：
Steciwko, Andrzej
中科院分区：
文献类型：
--
作者：
Bujnowska-Fedak, Maria Magdalena;Puchala, Edward;Steciwko, Andrzej
背景：远程家庭护理已被提出作为一个解决方案，以提供有效和负担得起的护理糖尿病患者的挑战。方法：共有100名成年2型糖尿病患者（分为需要胰岛素和不需要胰岛素两组）被纳入一项随机对照试验，旨在研究远程家庭监测的效果。实验组（n = 50）接受了家庭无线血糖监测仪和发射器，而对照组（n = 50）则遵循常规安排。结果：6个月后，实验组和对照组的HbA1c值均有总体下降。两组间的HbA1c值仅在非胰岛素需要患者中存在显著差异（IB组从6.95% +/- 0.82%降至6.66% +/- 0.86%，IIB组从7.21% +/- 2.02%降至7.2% +/- 1.86%,p = 0.02）。实验组报告的高血糖和低血糖事件明显减少。从远程监护中获益最多的患者包括年龄较大、受教育程度较高、患病时间较短、大部分时间待在家里的患者。实验组在生活质量测量和糖尿病控制感方面得分更高。受教育程度与无帮助使用远程监护系统的能力呈正相关（p = 0.045）。结论：虽然由于样本量小、观察期短而不能得出结论，但该研究表明远程家庭监测是在初级保健环境中控制2型糖尿病的有效工具。
Background: Telehome care has been proposed as a solution to the challenges of providing effective and affordable care for patients with diabetes. Methods: A total of 100 adult patients with type 2 diabetes-divided between insulin and noninsulin requiring-was enrolled in a randomized, controlled trial aimed at investigating the effects of telehome monitoring. The experimental group (n = 50) received an in-home wireless glucose monitor and transmitter, whereas the control group (n = 50) was instructed to follow the conventional arrangement. Results: There was an overall reduction in HbA1c values in both experimental and control groups after 6 months. A significant difference in HbA1c values between the groups was observed only among the noninsulin-requiring patients (decline from 6.95% +/- 0.82% to 6.66% +/- 0.86% in IB vs. 7.21% +/- 2.02% to 7.2% +/- 1.86% in IIB; p = 0.02). The experimental group reported considerably less hyperglycemic and hypoglycemic events. The profile of the patient who benefited the most from telemonitoring consisted of older, more educated patient who had acquired the disease relatively recently, and who spends most of the time at home. The experimental group had higher overall scores on quality of life measures and sense of control over diabetes. There was a positive association between educational attainment and ability to use the telemonitoring system without help (p = 0.045). Conclusions: Although not conclusive because of the small sample and short observation period, the study suggests that telehome monitoring is an effective tool in controlling type 2 diabetes in a primary care setting.