Zhu Xu, Williams Myia, Finuf Kayla, Patel Vidhi, Sinvani Liron, Wolf-Klein Gisele, Marziliano Allison, Nouryan Christian, Makaryus Amgad, Zeltser Roman, Tortez Leanne, Shkolnikov Tanya, Myers Alyson, Pekmezaris Renee
Department of Medicine, Northwell Health, Manhasset, NY.
Institute for Health Innovations and Outcomes Research, Northwell Health, Manhasset, NY.
Diabetes Spectr. 2022 Feb 15;35(1):118-128. doi: 10.2337/ds21-0023. Epub 2022 Feb 8.
Telehealth has emerged as an evolving care management strategy that is playing an increasingly vital role, particularly with the onset of the coronavirus disease 2019 pandemic. A meta-analysis of 20 randomized controlled trials was conducted to test the effectiveness of home telemonitoring (HTM) in patients with type 2 diabetes in reducing A1C, blood pressure, and BMI over a median 180-day study duration. HTM was associated with a significant reduction in A1C by 0.42% ( = 0.0084). Although we found statistically significant changes in both systolic and diastolic blood pressure (-0.10 mmHg [ = 0.0041] and -0.07 mmHg [ = 0.044], respectively), we regard this as clinically nonsignificant in the context of HTM. Comparisons across different methods of transmitting vital signs suggest that patients logging into systems with moderate interaction with the technology platform had significantly higher reductions in A1C than those using fully automatic transmission methods or fully manual uploading methods. A1C did not vary significantly by study duration (from 84 days to 5 years). HTM has the potential to provide patients and their providers with timely, up-to-date information while simultaneously improving A1C.
远程医疗已成为一种不断发展的护理管理策略,正发挥着越来越重要的作用,尤其是在2019年冠状病毒病大流行之际。进行了一项对20项随机对照试验的荟萃分析,以测试家庭远程监测(HTM)对2型糖尿病患者在为期180天的中位研究期间降低糖化血红蛋白(A1C)、血压和体重指数(BMI)的有效性。HTM与A1C显著降低0.42%相关( = 0.0084)。尽管我们发现收缩压和舒张压均有统计学上的显著变化(分别为-0.10 mmHg [ = 0.0041]和-0.07 mmHg [ = 0.044]),但在HTM的背景下,我们认为这在临床上无显著意义。对不同生命体征传输方法的比较表明,登录与技术平台有适度交互的系统的患者,其A1C降低幅度显著高于使用全自动传输方法或完全手动上传方法的患者。A1C在研究持续时间(从84天到5年)内没有显著变化。HTM有潜力为患者及其医疗服务提供者提供及时、最新的信息,同时改善A1C。