Randomized controlled trial of technology-assisted case management in low-income adults with type 2 diabetes: Effect on quality of life and blood pressure.
| Autor: | Egede LE; Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, USA.; Center for Advancing Population Science, Medical College of Wisconsin, USA., Dawson AZ; Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, USA.; Center for Advancing Population Science, Medical College of Wisconsin, USA., Walker RJ; Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, USA.; Center for Advancing Population Science, Medical College of Wisconsin, USA., Garraci E; Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, USA.; Center for Advancing Population Science, Medical College of Wisconsin, USA., Knapp RG; Department of Public Health Services, College of Medicine, Medical University of South Carolina, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of telemedicine and telecare [J Telemed Telecare] 2024 Jan; Vol. 30 (1), pp. 107-115. Date of Electronic Publication: 2021 Jul 12. |
| DOI: | 10.1177/1357633X211028491 |
| Abstrakt: | Introduction: A novel randomized controlled trial tested the efficacy of a technology-assisted case management program in a low income, rural population previously where nurses titrated medication over the phone instead of in a clinic. The primary analysis showed significant improvement in glycemic control at 6 months post-randomization decreasing hemoglobin A1c by 1%. This study aimed to test if the intervention was also effective at decreasing blood pressure without compromising quality of life. Methods: A total of 113 adults with poorly controlled diabetes (hemoglobin A1c ≥ 8%) were randomly assigned to the technology-assisted case management intervention or usual care. Participants received a 2-in-1 telehealth system to monitor glycemic and blood pressure control, which was uploaded daily to a central server. A nurse case manager was trained to titrate medication under physician supervision every 2 weeks based on the readings. Outcomes were blood pressure and quality of life (12-item Short-Form Health Survey) at 6 months. Baseline adjusted mixed models using a random intercept were used to evaluate change at 6 months for the technology-assisted case management intervention group compared to usual care. Results: There were no statistically significant differences in systolic blood pressure, physical component of quality of life, or mental component of quality of life between the technology-assisted case management and control group. However, there was a significant change in diastolic blood pressure over time, with the technology-assisted case management group decreasing at 6 months ( p = .05), whereas the control group remained stable. Conclusions: Technology-assisted case management by a nurse with medication titration under physician supervision was efficacious in improving diastolic blood pressure without compromising quality of life in low-income rural adults with diabetes. Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| Databáze: | MEDLINE |
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