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II型糖尿病的高级远程医疗培训与临床结果:一项试点研究。

Advanced Telemedicine Training and Clinical Outcomes in Type II Diabetes: A Pilot Study.

作者信息

Merrill Colton B, Roe Jason M, Seely Kevin D, Brooks Benjamin

机构信息

Rocky Vista University, Department of Research and Scholarly Activity, College of Osteopathic Medicine, Ivins, Utah, USA.

出版信息

Telemed Rep. 2022 Jan 11;3(1):15-23. doi: 10.1089/tmr.2021.0039. eCollection 2022.

Abstract

COVID-19 caused a dramatic increase in the scope and utilization of telemedicine. However, the sustainability of the permanent integration of telemedicine in the management of chronic disease beyond the pandemic is still enigmatic. The purpose of this retrospective chart review was to analyze the effect of advanced training in telemedicine on clinical outcomes in type II diabetes mellitus (T2DM) in the United States. A retrospective chart review was conducted in 104 deidentified patients with diabetes from 28 specialized telemedicine agency physicians who had received specialized telemedicine training. After establishing exclusion criteria, the charts of 59 T2DM patients were evaluated. Glycated hemoglobin (HbA1c) percentage and body mass index (BMI) were used as quantitative endpoints. Visit consistency, mediation data, and compliance data were also studied. The mean change in HbA1c for the 42 patients who met the inclusion criteria for evaluating HbA1c ( = 42) was -0.429%. The largest decrease in HbA1c was 5.4%, and the most significant increase was 3.9%. The mean change in BMI for the 16 patients who met the inclusion criteria for evaluating BMI ( = 16) was -2.175 kg/m. The largest decrease in BMI was 9.5 kg/m and the largest increase was +0.7 kg/m. The average number of visits for patients with a decrease in HbA1c was 3.45. The average number of visits for patients with an increase in HbA1c was 2.62. Outcomes of telemedicine providers with training are comparable with the standard of care. Advanced telemedicine training and its effect on clinical outcomes in the management of chronic disease warrant further investigation. For telemedicine to become a mainstay in U.S. medicine, a standard of best practices should be evaluated and available for providers who wish to continue telehealth care delivery.

摘要

新冠疫情导致远程医疗的范围和使用率急剧上升。然而,疫情之后远程医疗能否永久性融入慢性病管理仍不明朗。本回顾性病历审查的目的是分析远程医疗高级培训对美国II型糖尿病(T2DM)临床结局的影响。对来自28位接受过远程医疗专门培训的远程医疗机构专科医生的104例身份信息已消除的糖尿病患者进行了回顾性病历审查。确定排除标准后,对59例T2DM患者的病历进行了评估。糖化血红蛋白(HbA1c)百分比和体重指数(BMI)用作定量终点。还研究了就诊一致性、调解数据和依从性数据。符合HbA1c评估纳入标准的42例患者(n = 42)的HbA1c平均变化为-0.429%。HbA1c最大降幅为5.4%,最大增幅为3.9%。符合BMI评估纳入标准的16例患者(n = 16)的BMI平均变化为-2.175kg/m²。BMI最大降幅为9.5kg/m²,最大增幅为+0.7kg/m²。HbA1c下降患者的平均就诊次数为3.45次。HbA1c上升患者的平均就诊次数为2.62次。接受过培训的远程医疗服务提供者的结局与护理标准相当。远程医疗高级培训及其对慢性病管理临床结局的影响值得进一步研究。为使远程医疗成为美国医疗的支柱,应评估最佳实践标准并提供给希望继续提供远程医疗服务的提供者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/481d/8989092/5c1aac7a140e/tmr.2021.0039_figure1.jpg

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