Division of Endocrinology, The Hospital for Sick Children, Canada.
Department of Nutritional Sciences, University of Toronto, Canada.
J Telemed Telecare. 2020 Jun;26(5):271-277. doi: 10.1177/1357633X18816254. Epub 2018 Dec 10.
Implementation of telemedicine has been shown to improve health outcomes, such as body mass index (BMI). However, it is unclear whether telemedicine is useful alongside traditional weight-management programmes for adolescents with complex obesity. The objective was to evaluate implementation of the Ontario Telemedicine Network (OTN), a videoconferencing programme, as an adjunctive tool to face-to-face counselling within the setting of an established interdisciplinary obesity treatment programme.
Our observational cohort included two groups of adolescents enrolled in a clinical obesity-management programme over a two year period. Adolescents ( = 50) in group 1 attended both in-person and virtual visits (OTN group), and adolescents ( = 50) in group 2 received only in-person visits (comparison group). Within the OTN group, satisfaction survey responses were compared between patients and healthcare professionals. Change in BMI per month, paediatric quality of life scores, session attendance and demographic variables were compared between groups.
OTN subjects averaged 4.9 telehealth visits per adolescent over the two year programme. Both OTN and comparison groups had similar changes in BMI ( = 0.757), with increases over time ( = 0.042). Paediatric quality of life scores in both groups improved over time compared to baseline ( < 0.001), with higher scores for children compared to parental-reported child scores ( = 0.008). Both adolescents and healthcare professionals using the OTN were similarly satisfied with their experience.
Adjunctive use of the OTN within the setting of a weight-management programme is feasible, well accepted by families and healthcare providers, and led to similar outcomes compared to usual care.
远程医疗的实施已被证明可以改善健康结果，例如体重指数 (BMI)。然而，对于患有复杂肥胖症的青少年，远程医疗是否与传统的体重管理计划一起使用是有益的，目前尚不清楚。目的是评估安大略省远程医疗网络 (OTN) 的实施情况，这是一种视频会议计划，作为既定跨学科肥胖治疗计划中面对面咨询的辅助工具。
我们的观察性队列包括在两年内参加临床肥胖管理计划的两组青少年。组 1 的青少年（n=50）参加了面对面和虚拟访问（OTN 组），而组 2 的青少年（n=50）仅接受了面对面访问（对照组）。在 OTN 组中，比较了患者和医疗保健专业人员对满意度调查的回应。比较了两组之间 BMI 每月变化、儿科生活质量评分、就诊次数和人口统计学变量。
OTN 组的青少年在两年的项目中平均进行了 4.9 次远程健康访问。OTN 组和对照组的 BMI 变化均相似（=0.757），随着时间的推移呈增加趋势（=0.042）。与基线相比，两组的儿科生活质量评分均随时间推移而提高（<0.001），儿童的评分高于父母报告的儿童评分（=0.008）。使用 OTN 的青少年和医疗保健专业人员对他们的体验同样感到满意。
在体重管理计划的背景下，辅助使用 OTN 是可行的，受到家庭和医疗保健提供者的广泛接受，并与常规护理相比产生了相似的结果。
