Management of Type 2 Diabetes Mellitus through Telemedicine

Carallo, Claudio; Scavelli, Faustina; Cipolla, Maurizio; Merante, Valentina; Medaglia, Valeria; Irace, Concetta; Gnasso, Agostino; Calabria, Progetto Diabete

doi:10.1371/journal.pone.0126858

Cited by 21 publications

(20 citation statements)

References 9 publications

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“…Legget et al [11] reported high diagnostic accuracy (97%) for rheumatological conditions using real-time televisual consultation with 58% of patients expressing a preference for telemedicine consultation. Similar studies support use of telemedicine in long-term management of diabetes [12][13][14].…”

Section: Applications Of Telemedicinesupporting

confidence: 61%

Is there a role for telemedicine in adult allergy services?

Krishna

Knibb

Huissoon

2016

Clin Experimental Allergy

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Telemedicine refers to the application of telecommunication and information technology (IT) in the delivery of health and clinical care at a distance or remotely and can be broadly considered in two modalities: store-and-forward and real-time interactive services.Preliminary studies have shown promising results in radiology, dermatology, intensive care, diabetes, rheumatology and primary care. However, the evidence is limited and hampered by small sample sizes, paucity of randomised controlled studies and lack of data relating to costeffectiveness, health related quality of life and patient and clinician satisfaction. This review appraises the evidence from studies that have employed telemedicine tools in other disciplines and makes suggestions for its potential applications in specific clinical scenarios in adult allergy services. Possible examples include: triaging patients to determine the need for allergy tests; pre-assessment for specialised treatments such as allergen immunotherapy; follow up to assess treatment response and side effects; and education in self-management plan including training updates for self-injectable adrenaline and nasal spray use. This approach might improve access for those with limited mobility or living far away from regional centres, as well as bringing convenience and cost savings for the patient and service provider. These potential benefits need to be carefully weighed against evidence of service safety and quality. Keys to success include delineation of appropriate clinical scenarios, patient selection, training, IT support and robust information governance framework. Welldesigned prospective studies are needed to evaluate its role.

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Section: Applications Of Telemedicinesupporting

confidence: 61%

Is there a role for telemedicine in adult allergy services?

Krishna

Knibb

Huissoon

2016

Clin Experimental Allergy

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“…Recently many studies indicated that mobile medical intervention tools are effective in a wide range of areas for both disease management and lifestyle changes. [4][5][6][7][8] Some studies have shown that among diverse computer-based technologies, mobile phone interventions for diabetes self-management can significantly reduce hemoglobin A1c (HbA1c) levels. 9,10 In treatment with T2D, as recommended by the Chinese Guideline for Diabetes Prevention and Treatment and from the American Diabetes Association (ADA) guideline, insulin therapy is one of the best choices for T2D patients who could not get well glucose control by at least one oral antidiabetic drug (OAD).…”

Section: Introductionmentioning

confidence: 99%

<p>Achieving Effective and Efficient Basal Insulin Optimal Management by Using Mobile Health Application (APP) for Type 2 Diabetes Patients in China</p>

Cai

Zhang

Lin

et al. 2020

DMSO

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Aim: To evaluate the effectiveness of the mobile health application (APP) education in basal insulin optimal management program for insulin-naive type 2 diabetes (T2D) patients in China. Methods: The basal insulin optimal management program was launched in 297 hospitals in China, throughout the six main regions of China. A total of 17,208 insulin-naive patients with T2D who started to use basal insulin were screened. The mobile health APP was downloaded in each recruited patient's mobile phone and the doctor's mobile phone. Then, according to the instructions and education materials in the APP, these patients began their self-management of insulin dosage titrations and contacted their doctors by APP if they need help. Results: Overall, 12,530 patients with T2D were finally included in the analysis. The average age was 51.97±12.76 years, and 58% of them were males. The average body mass index is 24.46±3.83 kg/m 2 , and the average HbA1c at baseline was 8.33±2.11% with 24% of the subjects reaching the target of HbA1c<7.0% at baseline. After 3 months of treatment and educations through the APP, HbA1c decreased significantly from baseline (−1.02±1.72%), with 59% of the patients reaching HbA1c<7.0%. After 6 months, the glycemic control of HbA1c also decreased from baseline significantly (−1.01±1.67%). Dosage of insulin daily was 0.23±0.09 IU/kg at baseline, and 0.23±0.23 IU/kg after 6 months of treatment. Regarding the profiles of hypoglycemia treatment, 3145 patients received basal insulin in combination with mono oral anti-diabetic drug (OAD), 1204 patients with dual OADs, 208 patients with triple OADs, and 17 patients with quarter OADs. Conclusion: Patients could benefit from the basal insulin optimal management program in self-management by using mobile health APP educations. For T2D patients who are going to start insulin treatment, mobile health APP can help them to reach the target of glycemic control with appropriate dosage of insulin.

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“…The intervention groups were mostly compared with a group receiving usual care [21-25,27,29,30,32,33], with a specialist outpatient and a nurse practitioner clinic [28] or in one case through general correspondence by email [31]. …”

Section: Resultsmentioning

confidence: 99%

The Effectiveness of Information Technology-Supported Shared Care for Patients With Chronic Disease: A Systematic Review

Kooij¹,

Groen²,

Harten³

2017

J Med Internet Res

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BackgroundIn patients with chronic disease, many health care professionals are involved during treatment and follow-up. This leads to fragmentation that in turn may lead to suboptimal care. Shared care is a means to improve the integration of care delivered by various providers, specifically primary care physicians (PCPs) and specialty care professionals, for patients with chronic disease. The use of information technology (IT) in this field seems promising.ObjectiveOur aim was to systematically review the literature regarding the effectiveness of IT-supported shared care interventions in chronic disease in terms of provider or professional, process, health or clinical and financial outcomes. Additionally, our aim was to provide an inventory of the IT applications' characteristics that support such interventions.MethodsPubMed, Scopus, and EMBASE were searched from 2006 to 2015 to identify relevant studies using search terms related to shared care, chronic disease, and IT. Eligible studies were in the English language, and the randomized controlled trials (RCTs), controlled trials, or single group pre-post studies used reported on the effects of IT-supported shared care in patients with chronic disease and cancer. The interventions had to involve providers from both primary and specialty health care. Intervention and IT characteristics and effectiveness—in terms of provider or professional (proximal), process (intermediate), health or clinical and financial (distal) outcomes—were extracted. Risk of bias of (cluster) RCTs was assessed using the Cochrane tool.ResultsThe initial search yielded 4167 results. Thirteen publications were used, including 11 (cluster) RCTs, a controlled trial, and a pre-post feasibility study. Four main categories of IT applications were identified: (1) electronic decision support tools, (2) electronic platform with a call-center, (3) electronic health records, and (4) electronic communication applications. Positive effects were found for decision support-based interventions on financial and health outcomes, such as physical activity. Electronic health record use improved PCP visits and reduced rehospitalization. Electronic platform use resulted in fewer readmissions and better clinical outcomes—for example, in terms of body mass index (BMI) and dyspnea. The use of electronic communication applications using text-based information transfer between professionals had a positive effect on the number of PCPs contacting hospitals, PCPs’ satisfaction, and confidence.ConclusionsIT-supported shared care can improve proximal outcomes, such as confidence and satisfaction of PCPs, especially in using electronic communication applications. Positive effects on intermediate and distal outcomes were also reported but were mixed. Surprisingly, few studies were found that substantiated these anticipated benefits. Studies showed a large heterogeneity in the included populations, outcome measures, and IT applications used. Therefore, a firm conclusion cannot be drawn. As IT applications are developed and imp...

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Management of Type 2 Diabetes Mellitus through Telemedicine

Cited by 21 publications

References 9 publications

Is there a role for telemedicine in adult allergy services?

Is there a role for telemedicine in adult allergy services?

<p>Achieving Effective and Efficient Basal Insulin Optimal Management by Using Mobile Health Application (APP) for Type 2 Diabetes Patients in China</p>

The Effectiveness of Information Technology-Supported Shared Care for Patients With Chronic Disease: A Systematic Review

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