Use of Home Telehealth Monitoring with Active Medication Therapy Management by Clinical Pharmacists in Veterans with Poorly Controlled Type 2 Diabetes Mellitus

McFarland, M. Shawn; Davis, Kristen; Wallace, Jessica L.; Wan, Jim Y.; Cassidy, Regina; Morgan, Tommie J.; Venugopal, Dharapuram

doi:10.1002/j.1875-9114.2011.01038.x

Cited by 65 publications

(61 citation statements)

References 17 publications

(41 reference statements)

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“…34 Interventions that use telemonitoring combined with another supportive strategy (such as active case management or care coordination) to improve glycemic control show higher potential for sustained post-intervention effect. [35][36][37][38] While there has been a growing number of such behavioral randomized trials or comprehensive multifaceted interventions, few have presented longitudinal outcomes data for improved health equity in disadvantaged populations with type 2 diabetes. Collectively, such studies will lead toward a better understanding of some of the root causes and variations of health equity, as well as potential interventions for improving equity in healthcare across different populations.…”

Section: Discussionmentioning

confidence: 99%

Geographic and Racial/Ethnic Variations in Patterns of Multimorbidity Burden in Patients with Type 2 Diabetes

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Geographic and Racial/Ethnic Variations in Patterns of Multimorbidity Burden in Patients with Type 2 Diabetes

et al. 2014

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“…Our results are generalizable to telemonitoring programs that include pharmacists who are authorized to make dose adjustments as part of the study program because most patients in this study were treated using this approach. However, although pharmacist-involved telemonitoring programs are emerging, [22][23][24][25] this is not a generally available option for most telemonitoring programs.…”

Section: Study Limitationsmentioning

confidence: 99%

The Utah Remote Monitoring Project: Improving Health Care One Patient at a Time

Shane‐McWhorter

Lenert

Petersen

et al. 2014

Diabetes Technology & Therapeutics

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Background: The expanding role of technology to augment diabetes care and management highlights the need for clinicians to learn about these new tools. As these tools continue to evolve and enhance improved outcomes, it is imperative that clinicians consider the role of telemonitoring, or remote monitoring, in patient care. This article describes a successful telemonitoring project in Utah. Subjects and Methods: This was a nonrandomized prospective observational preintervention-postintervention study, using a convenience sample. Patients with uncontrolled diabetes and/or hypertension from four rural and two urban primary care clinics and one urban stroke center participated in a telemonitoring program. The primary clinical outcome measures were changes in hemoglobin A1C (A1C) and blood pressure. Other outcomes included fasting lipids, weight, patient engagement, diabetes knowledge, hypertension knowledge, medication adherence, and patient perceptions of the usefulness of the telemonitoring program. Results: Mean A1C decreased from 9.73% at baseline to 7.81% at the end of the program (P < 0.0001). Systolic blood pressure also declined significantly, from 130.7 mm Hg at baseline to 122.9 mm Hg at the end (P = 0.0001). Low-density lipoprotein content decreased significantly, from 103.9 mg/dL at baseline to 93.7 mg/ dL at the end (P = 0.0263). Other clinical parameters improved nonsignificantly. Knowledge of diabetes and hypertension increased significantly (P < 0.001 for both). Patient engagement and medication adherence also improved, but not significantly. Per questionnaires at study end, patients felt the telemonitoring program was useful. Conclusions: Telemonitoring improved clinical outcomes and may be a useful tool to help enhance disease management and care of patients with diabetes and/or hypertension.

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“…For example, the vast French IDEATEL diabetes project [47][48][49] and the telemedicine clinical trial of diabetes conducted by Leichter et al [50], [51] and Shultz et al [52] were excluded because they all incorporated both type 1 and type 2 diabetes. Studies by McFarland et al [53], Stone et al [54], Estrada et al [55] and Rodriguez-Idigoras et al [56] did not report anything about dropout numbers, reasons for dropout and behavioral changes but only presented data of medical conditions improvements. Other exclusions included, for example, Watson et al [57] who presents a pilot study, Eakin et al [58] who presents a preliminary trial plan and Davis et al [59] who presents the technology used at a remote clinic for lowincome community.…”

Section: Methodology Of the Meta-synthesismentioning

confidence: 94%

A Meta-Synthesis of Behavioral Outcomes from Telemedicine Clinical Trials for Type 2 Diabetes and the Clinical User-Experience Evaluation (CUE)

2015

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A worldwide demographic shift is in progress and the aged population proportion is projected to more than double across the next four decades. Our current healthcare models may not be adequate to handle this shift in demography, which may have serious consequences for the ageing population who are more prone to chronic diseases. One proposed remediation is to provide in-home assisted healthcare with technology-intervened approaches. Telemedicine, telehealth, e-health are paradigms found in scientific literature that provide clinical treatment through a technology intervention. In evidence-based medical science, these technology interventions are evaluated through clinical trials, which are targeted to measure improvements in medical conditions and the treatment's cost effectiveness. However, effectiveness of a technology also depends on the interaction pattern between the technology and its' users, especially the patients. This paper presents (1) a meta-synthesis of clinical trials for technology-intervened treatments of type 2 diabetes and (2) the Clinical User-Experience Evaluation (CUE). CUE is a recommendation for future telemedicine clinical trials that focuses on the patient as the user from Human-Computer Interaction (HCI) perspective and was developed as part of this research. The clinical trials reviewed were interpreted from a technology perspective and the non-medical or non-biological improvements of the users (patients) rather than the medical outcome. Results show that technology-intervened treatments provide positive behavior changes among patients and are potentially highly beneficial for chronic illness management such as type 2 diabetes. The results from the CUE method show how it complements clinical trials to capture patients' interaction with a technology.

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Use of Home Telehealth Monitoring with Active Medication Therapy Management by Clinical Pharmacists in Veterans with Poorly Controlled Type 2 Diabetes Mellitus

Cited by 65 publications

References 17 publications

Geographic and Racial/Ethnic Variations in Patterns of Multimorbidity Burden in Patients with Type 2 Diabetes

Geographic and Racial/Ethnic Variations in Patterns of Multimorbidity Burden in Patients with Type 2 Diabetes

The Utah Remote Monitoring Project: Improving Health Care One Patient at a Time

A Meta-Synthesis of Behavioral Outcomes from Telemedicine Clinical Trials for Type 2 Diabetes and the Clinical User-Experience Evaluation (CUE)

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