Citation

Esmatjes E, Jansà M, Roca D, Pérez-Ferre N, Del Valle L, Martínez-Hervás S, Ruiz De Adana M, Linares F, Batanero R, Vázquez F, Gomis R, De Solà-Morales O, Aguayo A, Castaño L, Gaztambide S, Vidal M, Calle A, Galindo M, Serrano-Ríos M, Federico FCS, De Adana MR, Rafael C. Diabetes Technol. Ther. 2014; 16(7): 435-441.

Copyright

(Copyright © 2014, Mary Ann Liebert)

DOI

10.1089/dia.2013.0313

PMID

unavailable

Abstract

OBJECTIVE: This study evaluated the impact of an Internet-based telematic system on the economic and clinical management of patients with type 1 diabetes mellitus. Research Design and Methods: This 6-month prospective, randomized, comparative, open, multicenter study included patients with type 1 diabetes >18 years old treated with multiple insulin doses and with a glycated hemoglobin (HbA1c) level of >8%. We compared an intervention group (IG) (two face-to-face and five telematic appointments) with a control group (CG) (seven face-to-face appointments). The variables studied were (1) patient and healthcare team costs, (2) metabolic control, (3) knowledge of diabetes, (4) quality of life, and (5) self-care treatment adherence.

RESULTS: Of the 154 patients included, 118 (76.6%) completed the study (IG, 54; CG, 64). The time used by the CG to follow the program was 823±645min versus 353±222min in the IG (P<0.0001). Compared with the CG, the IG required less healthcare time from the professionals (288±105min vs. 232±89min; P<0.001). HbA1c improved in both groups (IG, 9.2±1.5% [77.0±17.0mmol/mol] vs. 8.7±1.5% [71.6±17.0mmol/mol] [P<0.001]; CG, 9.2±0.9% [77.0±10.0mmol/mol] vs. 8.6±0.9% [70.5±10.0mmol/mol] [P<0.001], as did knowledge and self-care treatment adherence.

CONCLUSIONS: The use of interactive telematic appointments in subjects with type 1 diabetes and inadequate metabolic control is an efficient strategy, providing results comparable to those of face-to-face appointments in relation to improvement in glycemic control, knowledge acquisition, and self-care treatment adherence, with a significant reduction in the time used, especially by patients. © Copyright 2014, Mary Ann Liebert, Inc. 2014.

Language: en

Keywords

Humans; Adult; Female; Male; adult; Spain; human; Internet; Health Knowledge, Attitudes, Practice; female; male; Prospective Studies; quality of life; Quality of Life; randomized controlled trial; suicide attempt; clinical trial; Hypoglycemia; Hypoglycemic Agents; Insulin; Program Evaluation; Telemedicine; patient education; unemployment; article; comparative study; major clinical study; controlled study; priority journal; attitude to health; health care cost; follow up; multicenter study; prospective study; glucose blood level; blood; glucose; antidiabetic agent; hypoglycemia; insulin; insulin dependent diabetes mellitus; metabolism; self care; hemoglobin A1c; open study; hemoglobin blood level; teleconsultation; Patient Education as Topic; Self Care; program evaluation; Diabetes Mellitus, Type 1; Hemoglobin A, Glycosylated; Blood Glucose; glycosylated hemoglobin; Medication Adherence; telemedicine; metabolic regulation; medication compliance; hemoglobin A1c protein, human