Using Telecommunication Technology to Manage Children with Diabetes: The Computer-Linked Outpatient Clinic (CLOC) Study

Marrero, David G.; Vandagriff, Julie L.; Kronz, Kathy; Fineberg, Naomi S.; Golden, Michael P.; Msn, Deborah Gray; Orr, Donald P.; Wright, James C.; Johnson, Nancy

doi:10.1177/014572179502100409

Cited by 105 publications

(110 citation statements)

References 22 publications

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“…In 14 (20,21,23,28,29,31,39,44,(51)(52)(53)58,59,64) of these, the guidelines were locally developed, in 11 studies (22,24,26,27,32,35,36,47,55,57,60) they were based on national guidelines, and in 2 studies (46,54) the source of the guidelines was not specified.…”

Section: Discussionmentioning

confidence: 99%

“…In 18 studies (21,(27)(28)(29)33,34,36,37,40,41,47,51,52,56,60,61,63,66), the outcomes were all reliably assessed (outcomes obtained from an automated system or a reported agreement between two raters Ͼ90% or Ն 0.8). Furthermore, 15 studies (20,22,26,32,35,39,44,46,50,53,54,57,59,62,64) included objective laboratory assessment of glycemic control.…”

Section: Study Qualitymentioning

confidence: 99%

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Interventions to Improve the Management of Diabetes in Primary Care, Outpatient, and Community Settings

et al. 2001

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OBJECTIVE -To review the effectiveness of interventions targeted at health care professionals and/or the structure of care in order to improve the management of diabetes in primary care, outpatient, and community settings. RESEARCH DESIGN AND METHODS-A systematic review of controlled trials evaluating the effectiveness of interventions targeted at health care professionals and aimed at improving the process of care or patient outcomes for patients with diabetes was performed. Standard search methods of the Cochrane Effective Practice and Organization of Care Group were used.RESULTS -A total of 41 studies met the inclusion criteria. The studies identified were heterogeneous in terms of interventions, participants, settings, and reported outcomes. In all studies, the interventions were multifaceted. The interventions were targeted at health care professionals only in 12 studies, at the organization of care only in 9 studies, and at both in 20 studies. Complex professional interventions improved the process of care, but the effect on patient outcomes remained less clear because such outcomes were rarely assessed. Organizational interventions that facilitated the structured and regular review of patients also showed a favorable effect on process measures. Complex interventions in which patient education was added and/or the role of a nurse was enhanced led to improvements in patient outcomes as well as the process of care.CONCLUSIONS -Multifaceted professional interventions and organizational interventions that facilitate structured and regular review of patients were effective in improving the process of care. The addition of patient education to these interventions and the enhancement of the role of nurses in diabetes care led to improvements in patient outcomes and the process of care. Diabetes Care 24:1821-1833, 2001D iabetes is a major and growing health care problem. Primarily because of the increasing prevalence of type 2 diabetes as well as the increase in cases of type 1 diabetes (1), it is expected that the number of people with diabetes will double by the year 2010 (2).Diabetes accounts for a huge burden of morbidity and mortality through micro-and macrovascular complications (3,4). However, it is now clear that strict control of blood glucose, blood pressure, and cholesterol can reduce the risk of diabetes-related complications (5-8). To achieve strict control, structured care is needed (9).Over the past 20 years, the responsibility for the care of people with diabetes has shifted away from hospitals to primary care (10,11). During this period, randomized trials have demonstrated that if regular review of patients is guaranteed, the standard of primary care can be as good or better than hospital outpatient care in the short term (9). Several guidelines and diabetes management programs have been developed nationally and locally to improve diabetes care in the community. However, empirical data suggest that compliance with diabetes clinical practice recommendations is inadequate in primary care (12)(13)(14...

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Section: Discussionmentioning

confidence: 99%

Section: Study Qualitymentioning

confidence: 99%

Interventions to Improve the Management of Diabetes in Primary Care, Outpatient, and Community Settings

et al. 2001

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“…Our study shares the limitations of previous studies, which include enrolling a small sample, following them for a brief period (maximum follow-up was 12 months in two studies [26,29], 6 months in four others, and 3 months in another one [24]), and losing about 10% of patients to follow-up. The strongest inference about the true magnitude of telecare effect on glycemic control comes from our meta-analysis.…”

Section: Secondary Outcomesmentioning

confidence: 91%

“…Systematic review and meta-analysis of the literature Two reviewers working independently considered six trials published in seven manuscripts (22)(23)(24)(25)(26)(27)(28) eligible for review, with perfect interobserver agreement (Table 2). One additional eligible study was presented as a poster at the 63rd Scientific Sessions of the American Diabetes Association in June 2003 (29).…”

Section: Secondary Outcomesmentioning

confidence: 99%

Telecare for Patients With Type 1 Diabetes and Inadequate Glycemic Control

et al. 2004

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OBJECTIVE -To determine the efficacy of telecare (modem transmission of glucometer data and clinician feedback) to support intensive insulin therapy in patients with type 1 diabetes and inadequate glycemic control.RESEARCH DESIGN AND METHODS -Thirty-one patients with type 1 diabetes on intensive insulin therapy and with HbA 1c Ͼ7.8% were randomized to telecare (glucometer transmission with feedback) or control (glucometer transmission without feedback) for 6 months. The primary end point was 6-month HbA 1c . To place our findings in context, we pooled HbA 1c change from baseline reported in randomized trials of telecare identified in a systematic review of the literature.RESULTS -Compared with the control group, telecare patients had a significantly lower 6-month HbA 1c (8.2 vs. 7.8%, P ϭ 0.03, after accounting for HbA 1c at baseline) and a nonsignificant fourfold greater chance of achieving 6-month HbA 1c Յ7% (29 vs. 7%; risk difference 21.9%, 95% CI Ϫ4.7 to 50.5). Nurses spent 50 more min/patient giving feedback on the phone with telecare patients than with control patients. Meta-analysis of seven randomized trials of adult patients with type 1 diabetes found a 0.4% difference (95% CI 0 -0.8) in HbA 1c mean change from baseline between the telecare and control groups.CONCLUSIONS -Telecare is associated with small effects on glycemic control in patients with type 1 diabetes on intensive insulin therapy but with inadequate glycemic control.

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“…Por lo tanto, aunque el diseño, desarrollo e implementación de los sistemas WSN/WBAN representa una tarea difícil con varias cuestiones de una elevada dificultad técnica, los beneficios de su utilización para la prevención, diagnóstico precoz y gestión de las enfermedades son múltiples y ampliamente documentados (141,(154)(155)(156)(157)(158)(159)(160) .…”

Section: Resultados De Las Redes Inalámbricas Aplicadas a La Medicinaunclassified

Desarrollo de un sistema de telemetría para el seguimiento postoperatorio de procedimientos en cirugía vascular: modelo in vitro

et al. 2017

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A Kattalin, por tu apoyo incondicional y por la ilusión que me das día a día. Contigo todo es más fácil.A mi familia, gracias por darme todo. A quienes me han enseñado.A quienes me apoyan.Y a quienes disfrutan conmigo.-Y de todo esto, ¿qué sacamos en limpio? -me preguntó en seguida.-¡Bah! -le contesté-, la cosa es matar el tiempo y excitar la imaginación.-¿Para qué?-Para darle carrera y que corra.-¿No será mejor aquietarla y darle reposo? -¡Ay amigo! He aquí mis dos grandes anhelos; el anhelo de acción y el anhelo de reposo. Llevo dentro de mí, y supongo que a usted le ocurrirá lo mismo, dos hombres, uno activo y otro contemplativo, uno guerrero y otro pacífico, uno enamorado de la agitación y otro del sosiego.El uno no tiene deseo ni satisfacción y el otro no tiene miedo ni final. Soliloquios y conversaciones Miguel de UnamunoJulio 1942. AGRADECIMIENTOSCuando todo esto empezó en el mes de Noviembre de 2012, nunca hubiera imaginado todo lo que estos años de esfuerzo, trabajo e ilusión iban a significar para mí. Ahora, cuando acabamos de dar el primer paso en un campo de la ciencia tan novedoso, me siento tremendamente agradecido a todos los que me han enseñado y ayudado en estos años y muy orgulloso de formar parte de un grupo de trabajo como éste. Quiero destacar que no hubiéramos llegado hasta aquí sin el apoyo, conocimiento, ilusión y perseverancia de cada una de las personas que, de una forma u otra, han colaborado en este proyecto.Espero que esto sea sólo el principio de algo más y que todo lo que hemos conseguido no se detenga aquí, sino que sigamos avanzando y descubriendo más cosas acerca de los sensores y de sus aplicaciones en cirugía vascular.En primer lugar, gracias de corazón a Pilar Marín. No tengo palabras para agradecer todo tu esfuerzo, dedicación, paciencia e ilusión en este trabajo.Gracias a Ana Aragón. ¿Recuerdas todas esas horas de laboratorio? Parte de esta tesis es tuya también.Al Dr. Serrano Hernando, por ser un referente profesional y también personal. Por inculcarnos una forma única de ver nuestra profesión. Gracias por el apoyo y las enseñanzas en estos años.Al Profesor Antonio Hernando Grande, por descubrirme el mundo del magnetismo y ayudarme desde el primer día. La ilusión que transmites es una de las piezas clave en todo esto.Gracias a Víctor López por hacer todo un poco más fácil. Tu ayuda, aunque insistas en negarlo, fue fundamental.Al Dr. Moñux, por tu ayuda desinteresada y motivación. Sin palabras, amigo.Al Servicio de Cirugía Vascular del Hospital Clínico San Carlos y, en especial, al Dr.Martínez López. Gracias por enseñarme tanto y dedicarme todo tu tiempo y esfuerzo. Tu labor es simplemente admirable. Gracias al Dr. Muela, por su paciencia y por guiarme muchas veces. Gracias a todos y cada uno de vosotros, los años ahí son inolvidables.A la Dra. Vega y al equipo de Cirugía Vascular del Hospital de Basurto, por acogerme con los brazos abiertos. Gracias por el apoyo y el esfuerzo que ha supuesto para vosotros mi tesis. Hasta dónde llegue este proyecto también depende de vosotr...

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Using Telecommunication Technology to Manage Children with Diabetes: The Computer-Linked Outpatient Clinic (CLOC) Study

Cited by 105 publications

References 22 publications

Interventions to Improve the Management of Diabetes in Primary Care, Outpatient, and Community Settings

Interventions to Improve the Management of Diabetes in Primary Care, Outpatient, and Community Settings

Telecare for Patients With Type 1 Diabetes and Inadequate Glycemic Control

Desarrollo de un sistema de telemetría para el seguimiento postoperatorio de procedimientos en cirugía vascular: modelo in vitro

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