Mortality risk for diabetes patients in a care coordination, home-telehealth programme

Abstract

We assessed a home monitoring/care coordination programme for veterans with diabetes. Patients enrolled in the programme (n = 387) were followed for four years and compared with a retrospective control group (n = 387). Each patient in the intervention group used a messaging device in the home that was connected by a conventional telephone line. Care coordinators monitored the answers from the devices daily so that early interventions could be made. There were significantly more deaths in the control group (n = 102, 26%) compared with the intervention group (n = 75, 19%). There was longer survival for the intervention group versus the control group (mean survival time 1348 vs 1278 days; P = 0.015). A multivariate analyses indicated that the telemonitoring programme was associated with reduced 4-year all-cause mortality (hazard ratio = 0.7, 95% CI 0.5-0.9, P = 0.013). The results suggest that daily management of patients with diabetes through home monitoring by a registered nurse reduces mortality.

Promoting Access Through Complementary eHealth Technologies: Recommendations for VA’s Home Telehealth and Personal Health Record Programs

“…Previous studies of veterans with chronic conditions who used CCHT have shown lower mortality 24 and healthcare utilization [25][26][27] , as well as improved quality of life 26 and more timely receipt of care 28 . Other work has found increased time to readmission among veterans with heart failure 29 , including a dose-response relationship 30,31 .…”

The Empirical Evidence for the Telemedicine Intervention in Diabetes Management

“…[56][57][58][59][60][61][62][63][64][65] Of these, five were reported by the same senior author with different coauthors. These VHA studies are presented here in historical order as a set, shown in Table 3.…”

“…64 The intervention consisted of an automated electronic messaging device that queried patients about their diabetes symptoms and general health on a daily basis. The device was connected to a regular telephone line monitored by nurse coordinators.…”

Interventions to Improve Veterans’ Access to Care: A Systematic Review of the Literature

“…Further, we identified a number of welldesigned studies that examined access interventions, but they were not included in our review because they did not include data regarding either actual or perceived access outcomes. [29][30][31][32][33][34][35][36][37][38][39][40] Therefore, there are studies that report on the impact of access interventions on downstream outcomes that are not included in this review. As discussed above, we suggest that future research examining access interventions collect and compare a broad range of perceived and actual access outcomes across groups.…”