Effect of home telemonitoring on glycemic and blood pressure control in primary care clinic patients with diabetes

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This is a review for the research article authored by Wakefield, B. J., Koopman, R. J., Keplinger, L. E., Bomar, M., Bernt, B., Johanning, J. L., ... & Mehr, D. R. (2014)



Introduction

The traditional face to face co-management of diabetes and hypertension patients is complex but can be augmented with in-home monitoring technologies that enable primary care providers to monitor these patients more frequently. These in-home monitoring can increase the number of non-clinic visit generated data points that help make changes to plan of care as need arise. The aim of this study was to evaluate the short-term effectiveness of these in-home devices in transmitting hemoglobin A1C (A1C) and systolic BP measurements (SBP) [1].

Method

The authors used a single-center randomized controlled clinical trial that compared in-home monitoring of patient type 2 diabetes A1C (≥8%) and SBP (>130 mmHg) (n= 55) and usual care of these patients (n=53) for a period of 12 weeks at six University of Missouri Family and Internal Medicine Clinics queried from an electronic medical record every 2 weeks during the study enrolment phase. Study subjects recruitment occurred between May 2009 and August 2010 from an initial pool of 1,343 subjects with 108 agreeing to participate. Of which 53 and 55 subjects were randomly assigned to intervention and control respectively [1].


Results

The authors found no statistically significant difference in A1C or SBP between the two groups at baseline, at 3 and 6 months follow up periods though there was gender difference in SBP at baseline [1].

Conclusion

The author concluded that practices need to be selective in their use of telemonitoring of patients because the addition of telemonitoring technology alone is unlikely to lead to improvements in the targeted outcome in the short-terms [1].


Remarks about the article

The article shows that healthcare information technology (HIT) alone is not sufficient to bring about improvement in healthcare outcomes. It important to point out that other similar studies found significant difference in the same outcome of interest.

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Reference

  1. 1.0 1.1 1.2 1.3 Wakefield, 2014. Effect of home telemonitoring on glycemic and blood pressure control in primary care clinic patients with diabetes http://online.liebertpub.com/doi/abs/10.1089/tmj.2013.0151