Impact of Remote Management of Diabetes via Computer: The 360 Study—A Proof-of-Concept Randomized Trial

Leichter, Steven B.; Bowman, Kelly; Adkins, Royce A; Jelsovsky, Zhihong

doi:10.1089/dia.2012.0323

Cited by 29 publications

(25 citation statements)

References 18 publications

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“…More recently, several meta-analyses examining published diabetes telemedicine programs determined that patients participating in telemedicine interventions in fact had greater reduction in HbA1c on average when compared with patients in non-telemedicine groups (Faruque et al, 2017;Heitkemper et al, 2017;Lee et al, 2017;Marcolino et al, 2013;Su et al, 2016a). Alongside these encouraging results, patients reported travel time savings and high satisfaction rates with telemedicine programs, and total clinician time spent was reduced by as much as 40% (Xu, 2018;Izquierdo et al, 2003;Bashshur et al, 2015;Leichter et al, 2013). Collectively, these findings affirm that telemedicine diabetes care models may produce similar or better health outcomes than in-person care models with greater time-and cost-efficiency.…”

Section: Telemedicine In Diabetes Carementioning

confidence: 99%

“…Telemedicine programs with visits that match usual care models for diabetes treatment have already demonstrated success in helping patients maintain or improve their health (Lee et al, 2017). For example, a proof-ofconcept randomized controlled trial on telemedicine for diabetes care that randomly assigned patients into either a telemedicine intervention group (two in-person visits and two telemedicine in-teractions over 12 months) or a control group (four in-person visits over 12 months) found no significant differences in HbA1c, blood pressure, blood lipids, or BMI between the two groups at 12 months (Leichter et al, 2013). The telemedicine intervention group displayed a significantly greater reduction in mean body weight compared with the control group (Leichter et al, 2013).…”

Section: Telemedicine In Diabetes Carementioning

confidence: 99%

“…For example, a proof-ofconcept randomized controlled trial on telemedicine for diabetes care that randomly assigned patients into either a telemedicine intervention group (two in-person visits and two telemedicine in-teractions over 12 months) or a control group (four in-person visits over 12 months) found no significant differences in HbA1c, blood pressure, blood lipids, or BMI between the two groups at 12 months (Leichter et al, 2013). The telemedicine intervention group displayed a significantly greater reduction in mean body weight compared with the control group (Leichter et al, 2013). A 3-year study in rural Montana also found that patients with diabetes who used telemedicine visits versus face-toface visits had similar, positive health outcomes (Ciemins et al, 2011).…”

Section: Telemedicine In Diabetes Carementioning

confidence: 99%

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Patient-Driven Diabetes Care of the Future in the Technology Era

Ashrafzadeh

Hamdy

2019

Cell Metabolism

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The growing burden of diabetes is fueled by obesity-inducing lifestyle behaviors including high-calorie diets and lack of physical activity. Challenges in access to diabetes specialists and educators, low adherence to medications, and inadequate motivational support for proper disease self-management contribute to poor glycemic control in patients with diabetes. Simultaneously, high patient volumes and low reimbursement rates limit physicians' time spent on lifestyle behavior counseling. These barriers to efficient diabetes care lead to high rates of diabetes-related complications, driving healthcare costs up and reducing the quality of patients' lives. Considering recent advancements in healthcare delivery technologies such as smartphone applications, telemedicine, m-health, device connectivity, machine-learning technology, and artificial intelligence, there is significant opportunity to achieve better efficiency in diabetes care and increase patient involvement in diabetes self-management, which ultimately may put an end to soaring diabetesrelated healthcare expenditures. This review explores the patient-driven diabetes care of the future in the technology era.

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Section: Telemedicine In Diabetes Carementioning

confidence: 99%

Section: Telemedicine In Diabetes Carementioning

confidence: 99%

Section: Telemedicine In Diabetes Carementioning

confidence: 99%

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Patient-Driven Diabetes Care of the Future in the Technology Era

Ashrafzadeh

Hamdy

2019

Cell Metabolism

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“…2). For example, the vast French IDEATEL diabetes project [47][48][49] and the telemedicine clinical trial of diabetes conducted by Leichter et al [50], [51] and Shultz et al [52] were excluded because they all incorporated both type 1 and type 2 diabetes. Studies by McFarland et al [53], Stone et al [54], Estrada et al [55] and Rodriguez-Idigoras et al [56] did not report anything about dropout numbers, reasons for dropout and behavioral changes but only presented data of medical conditions improvements.…”

Section: Methodology Of the Meta-synthesismentioning

confidence: 99%

A Meta-Synthesis of Behavioral Outcomes from Telemedicine Clinical Trials for Type 2 Diabetes and the Clinical User-Experience Evaluation (CUE)

2015

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A worldwide demographic shift is in progress and the aged population proportion is projected to more than double across the next four decades. Our current healthcare models may not be adequate to handle this shift in demography, which may have serious consequences for the ageing population who are more prone to chronic diseases. One proposed remediation is to provide in-home assisted healthcare with technology-intervened approaches. Telemedicine, telehealth, e-health are paradigms found in scientific literature that provide clinical treatment through a technology intervention. In evidence-based medical science, these technology interventions are evaluated through clinical trials, which are targeted to measure improvements in medical conditions and the treatment's cost effectiveness. However, effectiveness of a technology also depends on the interaction pattern between the technology and its' users, especially the patients. This paper presents (1) a meta-synthesis of clinical trials for technology-intervened treatments of type 2 diabetes and (2) the Clinical User-Experience Evaluation (CUE). CUE is a recommendation for future telemedicine clinical trials that focuses on the patient as the user from Human-Computer Interaction (HCI) perspective and was developed as part of this research. The clinical trials reviewed were interpreted from a technology perspective and the non-medical or non-biological improvements of the users (patients) rather than the medical outcome. Results show that technology-intervened treatments provide positive behavior changes among patients and are potentially highly beneficial for chronic illness management such as type 2 diabetes. The results from the CUE method show how it complements clinical trials to capture patients' interaction with a technology.

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“…It used telephone and Internet links to connect providers with diabetes patients, and it was aimed at determining the congruence between routine clinical telediabetes assessments and in-person care assessments. 31 Patients were randomly assigned to experimental or control groups in equal proportions. After 12 months of observation, no differences were observed between the two groups in terms of glycemic control, lipids, or body mass index.…”

Section: Telemedicine For Diabetes Managementmentioning

confidence: 99%

The Empirical Evidence for the Telemedicine Intervention in Diabetes Management

Bashshur

Shannon

Smith

et al. 2015

Telemedicine and e-Health

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Objective: The research presented here assesses the scientific evidence for the telemedicine intervention in the management of diabetes (telediabetes), gestational diabetes, and diabetic retinopathy. The impetus derives from the confluence of high prevalence of these diseases, increasing incidence, and rising costs, while telemedicine promises to ameliorate, if not prevent, type 2 diabetes and its complications. Materials and Methods: A purposeful review of the literature identified relevant publications from January 2005 to December 2013. These were culled to retain only credible research articles for detailed review and analysis. The search yielded approximately 17,000 articles with no date constraints. Of these, 770 appeared to be research articles within our time frame. A review of the abstracts yielded 73 articles that met the criteria for inclusion in the final analysis. Evidence is organized by research findings regarding feasibility/acceptance, intermediate outcomes (e.g., use of service, and screening compliance), and health outcomes (control of glycemic level, lipids, body weight, and physical activity.) Results: Definitions of telediabetes varied from study to study vis-à-vis diabetes subtype, setting, technology, staffing, duration, frequency, and target population. Outcome measures also varied. Despite these vagaries, sufficient evidence was obtained from a wide variety of research studies, consistently pointing to positive effects of telemonitoring and telescreening in terms of glycemic control, reduced body weight, and increased physical exercise. The major contributions point to telemedicine's potential for changing behaviors important to diabetes control and prevention, especially type 2 and gestational diabetes. Similarly, screening and monitoring for retinopathy can detect symptoms early that may be controlled or treated. Conclusions: Overall, there is strong and consistent evidence of improved glycemic control among persons with type 2 and gestational diabetes as well as effective screening and monitoring of diabetic retinopathy.

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Impact of Remote Management of Diabetes via Computer: The 360 Study—A Proof-of-Concept Randomized Trial

Cited by 29 publications

References 18 publications

Patient-Driven Diabetes Care of the Future in the Technology Era

Patient-Driven Diabetes Care of the Future in the Technology Era

A Meta-Synthesis of Behavioral Outcomes from Telemedicine Clinical Trials for Type 2 Diabetes and the Clinical User-Experience Evaluation (CUE)

The Empirical Evidence for the Telemedicine Intervention in Diabetes Management

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