Internet-based Diabetes Education and Case Management
Condition: Diabetes Mellitus; Hypertension
MeSH terms: Hypertension; Diabetes Mellitus
Study type: Interventional

Summary: 
      This study is comparing the effectiveness of web-based care management to either
      telephone-based care management or internet access alone, in patients with poorly controlled
      diabetes mellitus.
    

Detailed description: 
      Background:

      Patients with diabetes and elevated hemoglobin A1c (HbA1c) are at risk for diabetes-related
      complications. Care-management may be helpful in these patients, by providing direct contact
      between such high-risk patients and the healthcare system. Web-based systems have previously
      shown promise as a means of neutralizing access barriers such as scheduling and travel to
      appointments and may be of particular help in improving diabetes care.

      Objectives:

      We examined the efficacy of two methods of diabetes education and care management: (1) a
      traditional model that involved telephone contact and face-to-face encounters (2) a web-based
      model with access to a diabetes care management web site. We compared these interventions to
      a study group that received no education or care management but was provided with a computer
      and access to diabetes self-management websites.

      Methods:

      This study employed a randomized, parallel group design involving patients with diabetes
      mellitus and an elevated HbA1c ( 8.5%). Participants assigned to web-based care management
      received a notebook computer, Internet access and interacted with a care manager through a
      diabetes education and care management website. Participants receiving telephone-based care
      management interacted with a care manager using telephone and face-to-face contact. Both care
      management models employed medication algorithms to improve glucose and BP control. These
      care management groups were compared to a study group that had no care management but
      received a notebook computer and Internet access with their "home page" containing links to a
      series of diabetes self-management websites (i.e. computer only group). The primary outcome
      measures were HbA1c, blood pressure, and scores on the Problem Areas in Diabetes (PAID)
      questionnaire, each measured over 12-months.

      Status:

      Complete
    

Intervention name(s): Web-based care management; Telephone and face-to-face care management; Internet access alone
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): Participants interact with a care manager, sending and receiving messages using an internet portal that accepts uploads from glucose and BP meters; Participants interact with a care manager via face-to-face and telephone contact; Participants are given internet access and encouraged to seek diabetes information to help in their self management
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Diabetes mellitus; Hypertension; Telemedicine; Case management