The narrative synthesis provided mixed effects of CHITs on other clinical , psychosocial , behavioral , and knowledge outcomes .
Conclusions The use of CHITs appears to be more effective than usual care in improving glycemic control for patients with diabetes .
However , their effectiveness did not remain consistent over time and in other patient outcomes .
Objective To reveal the effects of consumer-oriented health information technologies ( CHITs ) on patient outcomes in diabetes management over time through systematic review and meta- analysis .
Practical Telemedicine for Veterans with Persistently Poor Diabetes Control: A Randomized Pilot Trial.
BACKGROUND Telemedicine-based diabetes management improves outcomes versus clinic care but is seldom implemented by healthcare systems . In order to advance telemedicine-based management as a practical option for veterans with persistent poorly controlled diabetes mellitus ( PPDM ) despite clinic-based care , we evaluated a comprehensive telemedicine intervention that we specifically design ed for delivery using existing Veterans Health Administration ( VHA ) clinical staffing and equipment . MATERIAL S AND METHODS We conducted a 6-month r and omized trial among 50 veterans with PPDM ; all maintained hemoglobin A1c ( HbA1c ) levels continuously > 9.0 % for > 1 year despite clinic-based management . Participants received usual care or a telemedicine intervention combining telemonitoring , medication management , self-management support , and depression management ; existing VHA clinical staff delivered the intervention . Using linear mixed models , we examined HbA1c , diabetes self-care ( measured by the Self-Care Inventory-Revised question naire ) , depression , and blood pressure . RESULTS At baseline , the model-estimated common HbA1c intercept was 10.5 % . By 6 months , estimated HbA1c had improved by 1.3 % for intervention participants and 0.3 % for usual care ( estimated difference , -1.0 % , 95 % confidence interval [ CI ] , -2.0 % , 0.0 % ; p = 0.050 ) . Intervention participants ' diabetes self-care ( estimated difference , 7.0 ; 95 % CI , 0.1 , 14.0 ; p = 0.047 ) , systolic blood pressure ( -7.7 mm Hg ; 95 % CI , -14.8 , -0.6 ; p = 0.035 ) , and diastolic blood pressure ( -5.6 mm Hg ; 95 % CI , -9.9 , -1.2 ; p = 0.013 ) were improved versus usual care by 6 months . Depressive symptoms were similar between groups . CONCLUSIONS A comprehensive telemedicine intervention improved outcomes among veterans with PPDM despite clinic-based care . Because we specifically design ed this intervention with scalability in mind , it may represent a practical , real-world strategy to reduce the burden of poor diabetes control among veterans
The narrative synthesis provided mixed effects of CHITs on other clinical , psychosocial , behavioral , and knowledge outcomes .
Conclusions The use of CHITs appears to be more effective than usual care in improving glycemic control for patients with diabetes .
However , their effectiveness did not remain consistent over time and in other patient outcomes .
Objective To reveal the effects of consumer-oriented health information technologies ( CHITs ) on patient outcomes in diabetes management over time through systematic review and meta- analysis .