Centre for Online Health, The University of Queensland, Brisbane, Australia.
Centre for Health Services Research, The University of Queensland, Brisbane, Australia.
Diabetes Technol Ther. 2020 Aug;22(8):623-638. doi: 10.1089/dia.2019.0489. Epub 2020 Mar 4.
Telediabetes may improve patient access to clinicians who specialize in the management of pediatric diabetes. Due to the diversity of telehealth modes, many different service models for pediatric telediabetes have been developed. This review describes pediatric telediabetes service models identified in the literature, investigates the reported changes in HbA1c of these interventions, and describes enablers and barriers to implementing a telediabetes service. Evaluation of current literature may inform the development and sustainability of telehealth services for pediatric diabetes management. Twenty-nine studies met inclusion criteria and were reviewed. This review has demonstrated that pediatric telediabetes can be delivered by remote monitoring and real-time videoconference modes. Overall, pediatric telediabetes increased interactions between patients and clinicians, improved access to specialized care, and facilitated increased diabetes monitoring. In some contexts, telediabetes also improved short-term glycemic control. Key enablers reported for telediabetes services were integration with existing workflows, dedicated staff, clinician and patient training, appropriate data security, technology with good usability, and the availability of technical support. Barriers included increases in patient responsibilities and clinician workload, and technical issues with equipment and software.
远程糖尿病管理可能会增加患者与擅长儿童糖尿病管理的临床医生的接触机会。由于远程医疗模式的多样性，已经开发出许多不同的儿科远程糖尿病服务模式。本综述描述了文献中确定的儿科远程糖尿病服务模式，调查了这些干预措施对糖化血红蛋白（HbA1c）的报告变化，并描述了实施远程糖尿病服务的促成因素和障碍。对现有文献的评估可以为儿童糖尿病管理的远程医疗服务的发展和可持续性提供信息。29 项研究符合纳入标准并进行了综述。本综述表明，远程监测和实时视频会议模式可用于提供儿科远程糖尿病管理。总体而言，儿科远程糖尿病增加了患者与临床医生之间的互动，改善了获得专科护理的机会，并促进了增加糖尿病监测。在某些情况下，远程糖尿病也改善了短期血糖控制。远程糖尿病服务的主要促成因素包括与现有工作流程的整合、专门的工作人员、临床医生和患者培训、适当的数据安全性、具有良好可用性的技术以及技术支持的可用性。障碍包括患者责任和临床医生工作量的增加，以及设备和软件的技术问题。
