A randomized controlled trial comparing a telemedicine therapeutic intervention with routine care in adults with type 1 diabetes mellitus treated by insulin pumps.
Source: Yaron, M., et al. 2019 - Pubmed ID: 30783823
Setting: Israel, Diabetes center
RCT
Follow up: 12 months
Sample size:
Total: 67
IG: 31
CG: 36
Inclusion criteria:
- Diabetes type 1 treated with insulin pump
- Age > 22 years
Home monitoring
- Glucometer
Webpage
- Downloading and transmitting data
Phone call
- Feedback and recommendations
Intervention: Patients download and transmit data once a month. Physicians review data and document recommendations. Study coordinator informed patients about updated recommendations via phone call. Face to face visits in clinic once in 6 months.
Duration: 12 months
Add on: –
Control group: Usual care with 3 month interval face to face visits with physician
Clinical effect:
- HbA1c →
- Hypoglycemic events →
- Diabetic ketoacidosis →
- Proportion achieved target HbA1c →
- QoL →
Patient safety:
- Hypoglycemic events →
- Diabetic ketoacidosis →
Patient experiences:
- High satisfaction
Staff experiences:
- Physicians spent a mean 4.6 min per transmission reviewing the data and documenting recommendations. The study coordinator spent a mean 3.4 min per contact providing feedback to patients, for a mean 7.8 transmissions per participant.
Investment:
Equipment/Materials
- Glucometer
Staff resources
- Development of website (https://www.professional.medtronicdiabetes.com/carelink-system)
Running:
Staff resources
- Monitoring, documenting and conducting feedback on clinical data
Organization:
- Direct total cost 24% higher in control group
- Indirect medical expenses decreased in intervention group by 22%
Health care utilization: NA