Remote Patient Monitoring and Clinical Outcomes for Postdischarge Patients with Type 2 Diabetes

被引:20
作者
Michaud, Tzeyu L. [1 ,2 ]
Siahpush, Mohammad [2 ]
Schwab, Robert J. [3 ]
Eiland, Leslie A. [4 ]
DeVany, Mary [5 ]
Hansen, Geri [5 ]
Slachetka, Tammy S. [5 ]
Boilesen, Eugene [6 ]
Tak, Hyo Jung [7 ]
Wilson, Fernando A. [7 ]
Wang, Hongmei [7 ]
Pagan, Jose A. [8 ,9 ,10 ]
Su, Dejun [1 ,2 ]
机构
[1] Univ Nebraska Med Ctr, Coll Publ Hlth, Ctr Reducing Hlth Dispar, 984340 Nebraska Med Ctr, Omaha, NE 68198 USA
[2] Univ Nebraska Med Ctr, Coll Publ Hlth, Dept Hlth Promot, Omaha, NE USA
[3] Univ Nebraska Med Ctr, Dept Internal Med, Div Gen Internal Med, Omaha, NE USA
[4] Univ Nebraska Med Ctr, Dept Internal Med, Div Diabet Endocrine & Metab, Omaha, NE USA
[5] Nebraska Med, TeleHlth Team, Omaha, NE USA
[6] Univ Nebraska Med Ctr, Coll Publ Hlth, Ctr Collaborat Res Design & Anal, Omaha, NE USA
[7] Univ Nebraska Med Ctr, Coll Publ Hlth, Dept Hlth Serv Res & Adm, Omaha, NE USA
[8] NYU, Coll Global Publ Hlth, Dept Publ Hlth Policy & Management, New York, NY USA
[9] New York Acad Med, Ctr Hlth Innovat, New York, NY USA
[10] Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA
关键词
telemedicine; telehealth; HbA1c; patient activation; disease management; SEX-SPECIFIC DIFFERENCES; RISK-FACTOR CONTROL; CARDIOVASCULAR RISK; TELEHEALTH PROGRAM; ACTIVATION MEASURE; HOME TELEHEALTH; HEALTH OUTCOMES; CARE; MANAGEMENT; VETERANS;
D O I
10.1089/pop.2017.0175
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The objective of this study was to evaluate changes in clinical outcomes for patients with type 2 diabetes (T2D) after a 3-month remote patient monitoring (RPM) program, and examine the relationship between hemoglobin A1c (HbA1c) outcomes and participant characteristics. The study sample included 955 patients with T2D who were admitted to an urban Midwestern medical center for any reason from 2014 to 2017, and used RPM for 3 months after discharge. Clinical outcomes included HbA1c, weight, body mass index (BMI), and patient activation scores. Logistic regression was used to estimate the likelihood of having a postintervention HbA1c <9% by patient characteristics, among those who had baseline HbA1c >9%. Most patients experienced decreases in HbA1c (67%) and BMI (58%), and increases in patient activation scores (67%) (P<0.001 in all 3 cases) at the end of RPM. Logistic regression analyses revealed that among patients who had HbA1c >9% at baseline, men (odds ratio [OR]=3.72; 95% confidence interval [CI], 1.43-9.64), those who had increased patient activation scores after intervention (OR=1.05; 95% CI, 1.01-1.09), those who had higher baseline patient activation scores, and those who had a greater number of biometric data uploads during the intervention (OR=1.02; 95% CI, 1.00-1.04) were more likely to have reduced their HbA1c to <9% at the end of RPM. RPM for postdischarge patients with T2D might be a promising approach for HbA1c control with increased patient engagement. Future studies with study designs that include a control group should provide more robust evidence.
引用
收藏
页码:387 / 394
页数:8
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