Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa, USA.
Telemed J E Health. 2012 Oct;18(8):575-9. doi: 10.1089/tmj.2011.0237. Epub 2012 Aug 8.
Home telehealth programs often focus on a single disease, yet many patients who need monitoring have multiple conditions. This study evaluated secondary outcomes from a clinical trial evaluating the efficacy of home telehealth to improve outcomes of patients with co-morbid diabetes and hypertension.
A single-center randomized controlled clinical trial compared two remote monitoring intensity levels (low and high) and usual care in patients with type 2 diabetes and hypertension being treated in primary care. Secondary outcomes assessed were knowledge (diabetes, hypertension, medications), self-efficacy, adherence (diabetes, medications), and patient perceptions of the intervention mode.
Knowledge scores improved in the high-intensity intervention group participants, but upon further analysis, we found the intervention effect was not mediated by gain in knowledge. No significant differences were found across the groups in self-efficacy, adherence, or patient perceptions of the intervention mode.
Home telehealth can enhance detection of key clinical symptoms that occur between regular physician visits. While our intervention improved glycemic and blood pressure control, the mechanism of the effect for this improvement was not clear.
家庭远程医疗项目通常专注于单一疾病，但许多需要监测的患者有多种疾病。本研究评估了评估家庭远程医疗改善共病糖尿病和高血压患者结局的疗效的临床试验的次要结局。
一项单中心随机对照临床试验比较了 2 种远程监测强度（低强度和高强度）和初级保健中 2 型糖尿病和高血压患者的常规护理。评估的次要结局是知识（糖尿病、高血压、药物）、自我效能、依从性（糖尿病、药物）以及患者对干预模式的看法。
高强度干预组参与者的知识评分有所提高，但进一步分析发现，干预效果不是通过知识的增加来介导的。各组之间在自我效能、依从性或患者对干预模式的看法方面均无显著差异。
家庭远程医疗可以增强对定期就诊之间发生的关键临床症状的检测。虽然我们的干预措施改善了血糖和血压控制，但改善效果的机制尚不清楚。
