Managing diabetes care using an integrated regional e-health approach

Abstract

A total of 175 patients with Types 1 and 2 diabetes in primary care and university hospital outpatient departments were randomized into a study group (n = 101) or usual care (n = 74). The study group used an e-health application with a diabetes management system and a home care link. Usual care did not involve e-health, i.e. the patients made regular general practitioner visits about every three months. After 12 months HbA1c decreased significantly in both groups of patients. The differences were small, but HbA1c was significantly lower in the study group than the controls. Diastolic blood pressure, fasting plasma glucose, serum total cholesterol, serum LDL-cholesterol and serum triglycerides were significantly lower in the study than in the control group. This was achieved with fewer visits by study patients to doctors and nurses. Use of e-health in diabetes care for 12 months was able to provide equivalent diabetic control to usual care, and improved cardiovascular risk factors.

The Impact of ICT on Health Promotion: A Randomized Experiment with Diabetic Patients

“…Our results present a less optimistic picture of the potential benefits of web platforms for the empowerment of patients with chronic diseases than some of the previous literature (Harno et al, 2006;Meigs et al, 2003;and McKay et al, 2001).…”

The use of information technology to enhance diabetes management in primary care: a literature review

“…Some studies indicate no improvements in HbA1c 14,26 and LDL-cholesterol. 14,21 However, the use of web based interventions was associated with statistically significant improvements in HbA1c and lipid parameters, 18,19,33,34 although the improvement in HbA1c may be reduced by the presence of co-morbidities. 35 Barriers and facilitators to using IT in diabetes care…”

Perceptions of Persons With Type 2 Diabetes Treated in Swedish Primary Health Care: Qualitative Study on Using eHealth Services for Self-Management Support (Preprint)

“…Fewer face-to-face visits might also imply changes in the patients' perception of self-management support as well as reconfiguring work activities for the diabetes nurse [56)]. Encouraging patients to share their self-monitored data with the diabetes nurse to a higher degree may become a trade-off for fewer visits, thus having health economic implications.…”