Telemed J E Health - Using telehealth to provide diabetes care to patients in rural Montana: findings from the promoting realistic individual self-management program.

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Resumo

JECTIVE: The objectives of this study were to demonstrate the feasibility of telehealth technology to provide a team approach to diabetes care for rural patients and determine its effect on patient outcomes when compared with face-to-face diabetes visits.MATERIALS AND METHODS: An evaluation of a patient-centered interdisciplinary team approach to diabetes management compared telehealth with face-to-face visits on receipt of recommended preventive guidelines, vascular risk factor control, patient satisfaction, and diabetes self-management at baseline and 1, 2, and 3 years postintervention.RESULTS: One-year postintervention the receipt of recommended dilated eye exams increased 31% and 43% among telehealth and face-to-face patients, respectively (p=0.28). Control of two or more risk factors increased 37% and 69% (p=0.21). Patient diabetes care satisfaction rates increased 191% and 131% among telehealth and face-to-face patients, respectively (p=0.51). A comparison of telehealth with face-to-face patients resulted in increased self-reported blood glucose monitoring as instructed (97% vs. 89%; p=0.63) and increased dietary adherence (244% vs. 159%; p=0.86), respectively. Receipt of a monofilament foot test showed a significantly greater improvement among face-to-face patients (17% vs. 35%; p=0.01) at 1 year postintervention, but this difference disappeared in years 2 and 3.CONCLUSIONS: Telehealth proved to be an effective mode for the provision of diabetes care to rural patients. Few differences were detected in the delivery of a team approach to diabetes management via telehealth compared with face-to-face visits on receipt of preventive care services, vascular risk factor control, patient satisfaction, and patient self-management. A team approach using telehealth may be a viable strategy for addressing the unique challenges faced by patients living in rural communities.

Resumo Limpo

jectiv object studi demonstr feasibl telehealth technolog provid team approach diabet care rural patient determin effect patient outcom compar facetofac diabet visitsmateri method evalu patientcent interdisciplinari team approach diabet manag compar telehealth facetofac visit receipt recommend prevent guidelin vascular risk factor control patient satisfact diabet selfmanag baselin year postinterventionresult oneyear postintervent receipt recommend dilat eye exam increas among telehealth facetofac patient respect p control two risk factor increas p patient diabet care satisfact rate increas among telehealth facetofac patient respect p comparison telehealth facetofac patient result increas selfreport blood glucos monitor instruct vs p increas dietari adher vs p respect receipt monofila foot test show signific greater improv among facetofac patient vs p year postintervent differ disappear year conclus telehealth prove effect mode provis diabet care rural patient differ detect deliveri team approach diabet manag via telehealth compar facetofac visit receipt prevent care servic vascular risk factor control patient satisfact patient selfmanag team approach use telehealth may viabl strategi address uniqu challeng face patient live rural communiti

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