J Am Pharm Assoc (2003). 2019 Mar-Apr;59(2S):S63-S66. doi: 10.1016/j.japh.2019.01.004. Epub 2019 Feb 7.
To evaluate whether clinical pharmacy specialist (CPS) services delivered using clinical video telehealth (CVT) is consistent with CPS services via face-to-face (FTF) visits in a cohort of patients with poorly controlled type 2 diabetes mellitus. In addition, the study aimed to evaluate the potential benefits for the patient with implementation of CVT services.
Single-center retrospective cohort study. FTF services provided at a single community-based outpatient clinic (CBOC). CVT services provided at a main campus targeting the same CBOC. Patients with type 2 diabetes mellitus (A1c > 7%) consulted for management by a CPS between April 2013 and October 2014 were included. The primary outcome was mean A1c reduction at 3 and 6 months. Secondary outcomes included time from consult placement to visit, average travel distance averted, and average travel time averted.
Mean A1c reduction at 3 months was 1.096 ± 1.8 for FTF services before CVT (P ≤ 0.0001), 1.839 ± 1.7 for FTF services after CVT (P ≤ 0.0001), and 2.262 ± 2.8 (P = 0.0004) for CVT services. At 6 months, the mean A1c reduction was 1.202 ± 1.9 (P ≤ 0.0001), 1.965 ± 2 (P ≤ 0.0001), and 2.610 ± 3.8 (P = 0.0004). At 6 months there was no statistical difference between groups. The average time in days from consult placement to initial visit decreased from 106.3 ± 24.5 to 46 ± 35.3 (P ≤ 0.0001). The average travel distance in miles averted per patient was 99.5 ± 20.3, and the average travel time in hours averted was 1.6 ± 0.3.
Diabetes care provided by a CPS via CVT was as effective for the management of type 2 diabetes compared to FTF management by a CPS. Implementation of telehealth services increased access to providers as shown by the reduction in time from consult placement until initial visit.
评估使用临床视频远程医疗（CVT）提供的临床药师专家（CPS）服务是否与通过面对面（FTF）就诊提供的 CPS 服务一致，研究对象为血糖控制不佳的 2 型糖尿病患者。此外，本研究旨在评估为患者实施 CVT 服务的潜在益处。
单中心回顾性队列研究。FTF 服务在一个社区门诊（CBOC）提供。CVT 服务在一个针对同一 CBOC 的主校区提供。2013 年 4 月至 2014 年 10 月期间，患有 2 型糖尿病（A1c＞7%）的患者接受 CPS 咨询管理。主要结局为 3 个月和 6 个月时的平均 A1c 降低值。次要结局包括从咨询到就诊的时间、平均避免的旅行距离和平均节省的旅行时间。
FTF 服务在引入 CVT 前的 3 个月平均 A1c 降低值为 1.096±1.8（P≤0.0001），FTF 服务在引入 CVT 后的 3 个月平均 A1c 降低值为 1.839±1.7（P≤0.0001），CVT 服务的 3 个月平均 A1c 降低值为 2.262±2.8（P=0.0004）。在 6 个月时，平均 A1c 降低值分别为 1.202±1.9（P≤0.0001）、1.965±2（P≤0.0001）和 2.610±3.8（P=0.0004）。在 6 个月时，各组之间没有统计学差异。从咨询到首次就诊的平均天数从 106.3±24.5 天减少到 46±35.3 天（P≤0.0001）。每位患者平均避免的旅行距离为 99.5±20.3 英里，平均节省的旅行时间为 1.6±0.3 小时。
与 CPS 通过 FTF 管理相比，CPS 通过 CVT 提供的糖尿病护理对 2 型糖尿病的管理同样有效。远程医疗服务的实施增加了患者与提供者的接触机会，这从咨询到首次就诊的时间缩短得到了体现。
