Improved Glycemic Control Through the Use of a Telehomecare Program in Patients with Diabetes Treated with Insulin

Abstract

Background: With the drastic surge in the prevalence of diabetes, the use of medical resources for management of diabetic patients increased markedly. This study aimed to evaluate the impact of telehomecare (THC) use on clinical efficacy, nursing interventions, and medical visits compared with the standard care in insulin-treated diabetic patients. Materials and Methods: A prospective noninferiority clinical trial was designed. Participants were assigned to either an intervention group provided with a THC system during 3 months or to a control group. Main outcome was the difference in A1c at 3 months compared with baseline. Secondary outcomes were the difference in A1c at 6 months compared with baseline, the number of medical visits during the 6-month period of the study, and nursing interventions during the 3 months on THC. Results: A total of 92 participants completed the study. A significant decrease in A1c levels was observed in the THC group (n = 45) compared with the control group (n = 47) at 3 months (-0.61% vs.-0.06%, respectively, P = 0.048) and at 6 months (-0.37% vs.-0.10%, respectively, P = 0.036). The THC group had an average of 0.6 medical visit compared with 1.0 in the control group (P < 0.001). An increase in nursing interventions (mainly e-mails) was noted in THC group (n = 14.7) compared with control group (n = 1.1). Conclusions: This THC program demonstrates improvement in glycemic control and a decrease in the number of medical visits. However, it is important to consider an additional burden in nursing interventions when implementing a THC program.

Investigating the Causes of Elderly People Leaving Home during Coronavirus Disease-19 Epidemic

“…Moreover, THC can help establish the service network between hospitals and first-aid providers, through which will facilitate the opportunity of better accessibility of the elderly to the services. In addition to the improvement of the management of the chronic condition as well as the increasing availability of health care, THC believes that it would decrease the health care expenses as well [16], [17]. Eventually, it should be noted in THC, the prioritizing THC, implemented according to the meaningful relationship of the demographic variables with health and sanitary needs.…”

Clinical Utility of a Digital Therapeutic Intervention in Indian Patients With Type 2 Diabetes Mellitus: 12-Week Prospective Single-Arm Intervention Study

“…In recent years, digital technologies have attracted increasing attention to enable lifestyle modification by patients and help them achieve the goal of self-management of diabetes to reduce the disease burden [11][12][13][14][15]. As a mostly remote intervention form, digital therapeutic interventions (DTIs) may not be as impactful as in-person counseling and follow-ups, but have the advantage of ease of communication, anytime-anywhere accessibility, and availability of information.…”

“…As a mostly remote intervention form, digital therapeutic interventions (DTIs) may not be as impactful as in-person counseling and follow-ups, but have the advantage of ease of communication, anytime-anywhere accessibility, and availability of information. A DTI overcomes the barrier of physical transportation, particularly in restricted conditions such as during the COVID-19 pandemic [12][13][14][15]. The machine learning capabilities through cloud computing and interactive interfaces of smartphones have made behavior modification possible based on personalized nudges, information sharing, and communication [12][13][14].…”

“…A DTI overcomes the barrier of physical transportation, particularly in restricted conditions such as during the COVID-19 pandemic [12][13][14][15]. The machine learning capabilities through cloud computing and interactive interfaces of smartphones have made behavior modification possible based on personalized nudges, information sharing, and communication [12][13][14]. The ease of intervention along with autonomy and constant reminders can keep a patient motivated in achieving the desired therapeutic goals.…”

“…The ease of intervention along with autonomy and constant reminders can keep a patient motivated in achieving the desired therapeutic goals. Several studies have demonstrated the role of digital technology such as digital therapeutic platforms, telehomecare systems, digitally enhanced diabetes self-management, education and support programs, as well as smartphone-based integrated online real-time diabetes care systems in the effective management of T2DM, without requiring escalation of existing medication [12][13][14][15][16][17]. However, there is also substantial variation in the reported intervention approaches and observed changes in outcome parameters.…”