Implementation of telehealth support for patients with type 2 diabetes using insulin treatment: an exploratory study.
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Date
2009-06-03
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Abstract
BACKGROUND Initiating and adjusting insulin treatment for people with type 2 diabetes T2D requires frequent clinician contacts both face to face and by telephone We explored the use of a telehealth system to offer additional support to these patients METHODS Twenty three patients with uncontrolled T2D were recruited from nine general practices to assess the feasibility and acceptability of telehealth monitoring and support for insulin initiation and adjustment The intervention included a standard algorithm for self titration of insulin dose a Bluetooth enabled glucose meter linked to a mobile phone an integrated diary to record insulin dose feedback of charted blood glucose data and telehealth nurse review with telephone follow up Additional contact with patients was initiated when no readings were transmitted for 3 days or when persistent hyper or hypoglycaemia was identified Reponses of patients and clinicians to the system were assessed informally RESULTS The mean SD patient age was 58 years 12 with 78 male The mean SD diabetes duration was 6 4 years 4 5 HbA1c at baseline was 9 5 2 2 and the decrease in HbA1c at three months was 0 52 0 91 with an insulin dose increase of 9 units 26 A mean SD of 160 93 blood glucose readings was transmitted per patient in these three months Practice nurses and general practitioners GPs viewed the technology as having the potential to improve patient care Most patients were able to use the equipment with training and welcomed review of their blood glucose readings by a telehealth nurse CONCLUSIONS Although the concept of telehealth monitoring is unfamiliar to most patients and practice nurses the technology improved the support available for T2D patients commencing insulin treatment
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Keywords
At risk for a particular disease or infection, Client, Access to information or data, Continuity of care, Acceptability, Low adherence to treatments, Unnecessary referrals and transportation, Efficiency, Pilot, Feasibility, Diabetes, Non-communicable diseases, Chronic care, Health education or promotion, Treatment adherence, Remote client-to-provider consultations (Telemedicine), Disease management, Data collection and reporting, Surveillance, Voice, Bluetooth, Raw data, Physiologic Biosensors, Decision support algorithm