Discussion Findings suggest that medically underserved patients with diabetes achieve glycemic benefit following HIT DSME interventions , with dissipating but significant effects at 12 months .
Telemedicine/telehealth interventions were the most successful HIT type because they incorporated interaction with educators similar to in-person DSME .
Conclusion These results are similar to in-person DSME in medically underserved patients , showing that well- design ed HIT DSME has the potential to increase access and improve outcomes for this vulnerable group
Objective The purpose of this systematic review and meta- analysis was to examine the effect of health information technology ( HIT ) diabetes self-management education ( DSME ) interventions on glycemic control in medically underserved patients .
Evaluation of a Remote Monitoring System for Diabetes Control.
PURPOSE The use of technology to implement cost-effective health care management on a large scale may be an alternative for diabetes management but needs to be evaluated in controlled trials . This study assessed the utility and cost-effectiveness of an automated Diabetes Remote Monitoring and Management System ( DRMS ) in glycemic control versus usual care . METHODS In this r and omized , controlled study , patients with uncontrolled diabetes on insulin were r and omized to use of the DRMS or usual care . Participants in both groups were followed up for 6 months and had 3 clinic visits at 0 , 3 , and 6 months . The DRMS used text messages or phone calls to remind patients to test their blood glucose and to report results via an automated system , with no human interaction unless a patient had severely high or low blood glucose . The DRMS made adjustments to insulin dose(s ) based on vali date d algorithms . Participants reported medication adherence through the Morisky Medication Adherence Scale-8 , and diabetes-specific quality of life through the diabetes Daily Quality of Life question naire . A cost-effectiveness analysis was conducted based on the estimated overall costs of DRMS and usual care . FINDINGS A total of 98 patients were enrolled ( 59 [ 60 % ] female ; mean age , 59 years ) ; 87 participants ( 89 % ) completed follow-up . HbA1c was similar between the DRMS and control groups at 3 months ( 7.60 % vs 8.10 % ) and at 6 months ( 8.10 % vs 7.90 % ) . Changes from baseline to 6 months were not statistically significant for self-reported medication adherence and diabetes-specific quality of life , with the exception of the Daily Quality of Life-Social/Vocational Concerns subscale score ( P = 0.04 ) . IMPLICATION S An automated system like the DRMS may improve glycemic control to the same degree as usual clinic care and may significantly improve the social/vocational aspects of quality of life . Cost-effectiveness analysis found DRMS to be cost-effective when compared to usual care and suggests DRMS has a good scale of economy for program scale up . Further research is needed to determine how to sustain the benefits seen with the automated system over longer periods
Discussion Findings suggest that medically underserved patients with diabetes achieve glycemic benefit following HIT DSME interventions , with dissipating but significant effects at 12 months .
Telemedicine/telehealth interventions were the most successful HIT type because they incorporated interaction with educators similar to in-person DSME .
Conclusion These results are similar to in-person DSME in medically underserved patients , showing that well- design ed HIT DSME has the potential to increase access and improve outcomes for this vulnerable group
Objective The purpose of this systematic review and meta- analysis was to examine the effect of health information technology ( HIT ) diabetes self-management education ( DSME ) interventions on glycemic control in medically underserved patients .