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Telemonitoring and Health Counseling for Self-Management Support of Patients With Type 2 Diabetes: A Randomized Controlled Trial
Luleå University of Technology, Department of Health Sciences, Nursing Care.ORCID iD: 0000-0002-3861-7298
Faculty of Medicine, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway; Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
Department of Nursing Sciences, Mid Sweden University, Östersund, Sweden.
Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
2017 (English)In: JMIR Diabetes, E-ISSN 2371-4379, Vol. 2, no 1, article id e10Article in journal (Refereed) Published
Abstract [en]

Background: The prevalence of diabetes is increasing among adults globally, and there is a need for new models of health care delivery. Research has shown that self-management approaches encourage persons with chronic conditions to take a primary role in managing their daily care. Objective: The objective of this study was to investigate whether the introduction of a health technology-supported self-management program involving telemonitoring and health counseling had beneficial effects on glycated hemoglobin (HbA1c), other clinical variables (height, weight, body mass index, blood pressure, blood lipid profile), and health-related quality of life (HRQoL), as measured using the Short Form Health Survey (SF-36) version 2 in patients with type 2 diabetes. Methods: This was a pragmatic randomized controlled trial of patients with type 2 diabetes. Both the control and intervention groups received usual care. The intervention group also participated in additional health promotion activities with the use of the Prescribed Healthcare Web application for self-monitoring of blood glucose and blood pressure. About every second month or when needed, the general practitioner or the diabetes nurse reviewed the results and the health care activity plan. Results: A total of 166 patients with type 2 diabetes were randomly assigned to the intervention (n=87) or control (n=79) groups. From the baseline to follow-up, 36 patients in the intervention group and 5 patients in the control group were lost to follow-up, and 2 patients died. Additionally, HbA1c was not available at baseline in one patient in the intervention group. A total of 122 patients were included in the final analysis after 19 months. There were no significant differences between the groups in the primary outcome HbA1c level (P=.33), and in the secondary outcome HRQoL as measured using SF-36. A total of 80% (67/87) of the patients in the intervention group at the baseline, and 98% (47/50) of the responders after 19-month intervention were familiar with using a personal computer (P=.001). After 19 months, nonresponders (ie, data from baseline) reported significantly poorer mental health in social functioning and role emotional subscales on the SF-36 (P=.03, and P=.01, respectively). Conclusions: The primary outcome HbA1c level and the secondary outcome HRQoL did not differ between groups after the 19-month follow-up. Those lost to follow-up reported significantly poorer mental health than did the responders in the intervention group.

Place, publisher, year, edition, pages
JMIR Publications , 2017. Vol. 2, no 1, article id e10
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Nursing
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Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-67144DOI: 10.2196/diabetes.6884OAI: oai:DiVA.org:ltu-67144DiVA, id: diva2:1170212
Note

Validerad;2018;Nivå 1;2018-01-02 (svasva)

Available from: 2018-01-02 Created: 2018-01-02 Last updated: 2018-02-08Bibliographically approved

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