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

Study design:

RCT

Follow up: 12 months

Patient group:

Sample size:

Total: 67

IG: 31

CG: 36

Inclusion criteria:

– Diabetes type 1 treated with insulin pump

– age > 22 years

Type of technology:

Home monitoring equipment
– Glucometer

Website
– Downloading and transmitting data

Phone call
– feedback and recommenda-tions

Intervention:

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/ Patient safety:

Clinical effect:

– HbA1c →

– Hypoglycemic events →

– Diabetic ketoacidosis →

– Proportion achieved target HbA1c →

– QoL →

Patient safety:

– Hypoglycemic events →

– Diabetic ketoacidosis →

Patient experiences/ Staff experiences:

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.

Costs and organization:

Investment:

Material

– Glucometer

Staff resources

– Development of website (https ://www.

profe ssion al.medtr onicd iabet es.com/carel ink-syste m).

 

 

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

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Information

“↑”: Statistically significant increase

“↓”: Statistically significant decrease

“→”: Statistically insignificant (no difference)