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远程患者监测可将医疗服务不足患者的糖化血红蛋白水平维持在较低水平长达 12 个月。

Remote patient monitoring sustains reductions of hemoglobin A1c in underserved patients to 12 months.

机构信息

Division of General Internal Medicine, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA.

Section of Health Systems Research and Policy, Department of Medicine, Medical University of South Carolina, 135 Rutledge Ave, MSC 591, Charleston, SC, USA.

出版信息

Prim Care Diabetes. 2021 Jun;15(3):459-463. doi: 10.1016/j.pcd.2021.01.005. Epub 2021 Jan 25.

Abstract

AIMS

We sought to determine whether underserved patients enrolled in a statewide remote patient monitoring (RPM) program for diabetes achieve sustained improvements in hemoglobin A at 6 and 12 months and whether those improvements are affected by demographic and clinical variables.

METHODS

Demographic and clinical variables were obtained at baseline, 6 months and 12 months. Baseline HbA1c values were compared with those obtained at 6 and 12 months via paired t-tests. A multivariable regression model was developed to identify patient-level variables associated with HbA change at 12 months.

RESULTS

HbA values were obtained for 302 participants at 6 months and 125 participants at 12 months. Compared to baseline, HbA values were 1.8% (19 mmol/mol) lower at 6 months (p < 0.01) and 1.3% (14 mmol/mol) lower at 12 months (p < 0.01). Reductions at 12 months were consistent across clinical settings. A regression model for change in HbA showed no statistically significant difference for patient age, sex, race, household income, insurance, or clinic type.

CONCLUSIONS

Patients enrolled in RPM had improved diabetes control at 6 and 12 months. Neither clinic type nor sociodemographic variables significantly altered the likelihood that patients would benefit from this type of technology. These results suggest the promise of RPM for delivering care to underserved populations.

摘要

目的

我们旨在确定在全州范围内远程患者监测(RPM)糖尿病计划中参与的服务不足患者是否在 6 个月和 12 个月时持续改善血红蛋白 A,并确定这些改善是否受到人口统计学和临床变量的影响。

方法

在基线、6 个月和 12 个月时获得人口统计学和临床变量。通过配对 t 检验比较基线 HbA1c 值与 6 个月和 12 个月时的 HbA1c 值。建立多变量回归模型以确定与 12 个月时 HbA 变化相关的患者水平变量。

结果

在 6 个月和 12 个月时分别获得了 302 名参与者和 125 名参与者的 HbA 值。与基线相比,HbA 值在 6 个月时降低了 1.8%(19mmol/mol)(p<0.01),在 12 个月时降低了 1.3%(14mmol/mol)(p<0.01)。在不同的临床环境中,12 个月的降幅是一致的。HbA 变化的回归模型显示,患者年龄、性别、种族、家庭收入、保险或诊所类型在统计学上没有显著差异。

结论

参与 RPM 的患者在 6 个月和 12 个月时糖尿病控制得到改善。诊所类型或社会人口统计学变量均未显著改变患者从这种技术中获益的可能性。这些结果表明 RPM 有希望为服务不足的人群提供护理。

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