Quality of diabetes care among patients managed by teleconsultation

Abstract

We studied a new teamwork-based teleconsultation model for treating patients with diabetes, where a specialist in diabetes care, a diabetes nurse and a patient attended by videoconference. The study series consisted of all the patients (n = 101) at three health centres in northern Finland whose care was provided by a single physician at a remote diabetes clinic. A total of 101 patients with diabetes (19 of type 1 and 82 of type 2) were studied at baseline and at 10-14 months after the first consultation. Mean HbA(1c) was 8.0% at baseline and 7.6% at follow-up (P = 0.007). The proportion of patients with poor glycaemic control decreased from 32% to 13%. Mean LDL cholesterol was 3.3 mmol/L at baseline and 2.7 mmol/L at follow-up (P < 0.001). The percentage of patients with optimum lipid levels increased from 20% to 50%. Mean systolic blood pressure was 146 mmHg at baseline and had decreased by 6 mmHg at follow-up (P = 0.004). The percentage of patients with poor blood pressure control decreased from 19% to 8%. The most common changes in medication were the introduction or modification of insulin treatment and the introduction of statin and antihypertensive drugs and acetylsalicylic acid. Although the study was uncontrolled, there were improvements in glucose and LDL cholesterol levels and blood pressure in patients who were managed by teleconsultation.

The views of health-care personnel about video consultation prior to implementation in primary health care in rural areas

“…VCs increase the possibility for ‘just in time diagnosis’ from specialist when there is no waiting time for visit by referral. It has been used in different settings and contexts in health care, for example, ophthalmology (Bergua et al ., 2009), endocrinology/diabetes management (Nikkanen et al ., 2008), cardiology (Boman et al ., 2009), dermatology (Edison et al ., 2011), and in psychiatry (Stain et al ., 2011). Another example is when a patient asks for a second opinion from another specialist physician (Törnqvist et al ., 2000; Visser et al ., 2010).…”

Diabetes care in the time of COVID‐19: video consultation as a means of diabetes management

“…HbA 1c levels appeared uncompromised over time in intervention groups compared to standard diabetes care, relative to either control or baseline values. All but two of the quantitative studies included in this review reported significant reduction in HbA 1c 23–26,28,29,31,33 . Maxwell et al .…”

“…All but two of the quantitative studies included in this review reported significant reduction in HbA1c. [23][24][25][26]28,29,31,33 23,31 The remaining three studies found there to be no significant change in LDL level at follow-up. 24,25,27 A significant decrease in overall cholesterol level was found by Rasmussen et al 28 Blood pressure.…”

“…Five of the studies were conducted in the USA: [27][28][29] The remaining four studies were conducted in the UK, Finland, Italy and Germany. [30][31][32][33] (Details are given in Appendix 2, available online at https://wchh. onlinelibrary.wiley.com.…”

Does nutritional counseling in telemedicine improve treatment outcomes for diabetes? A systematic review and meta-analysis of results from 92 studies

“…Of the 92 studies included, 98 different intervention groups were isolated: 17 NC, 32–44,46,47,55,65 46 MNF, 45,48,64,66–74,76–90,137 and 35 NNI. 75,91,93…”