Telemed J E Health - Effectiveness of home telehealth in comorbid diabetes and hypertension: a randomized, controlled trial.

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Resumo

CKGROUND: Increased emphasis is being placed on the critical need to control hypertension (HTN) in patients with diabetes.OBJECTIVE: The objective of this study was to evaluate the efficacy of a nurse-managed home telehealth intervention to improve outcomes in veterans with comorbid diabetes and HTN.DESIGN: A single-center, randomized, controlled clinical trial design comparing two remote monitoring intensity levels and usual care in patients with type 2 diabetes and HTN being treated in primary care was used.MEASUREMENTS: Primary outcomes were hemoglobin A1c and systolic blood pressure (SBP); secondary outcome was adherence.RESULTS: Intervention subjects experienced decreased A1c during the 6-month intervention period compared with the control group, but 6 months after the intervention was withdrawn, the intervention groups were comparable with the control group. For SBP, the high-intensity subjects had a significant decrease in SBP compared with the other groups at 6 months and this pattern was maintained at 12 months. Adherence improved over time for all groups, but there were no differences among the three groups.LIMITATIONS: Subjects had relatively good baseline control for A1c and SBP; minorities and women were underrepresented.CONCLUSIONS: Home telehealth provides an innovative and pragmatic approach to enhance earlier detection of key clinical symptoms requiring intervention. Transmission of education and advice to the patient on an ongoing basis with close surveillance by nurses can improve clinical outcomes in patients with comorbid chronic illness.

Resumo Limpo

ckground increas emphasi place critic need control hypertens htn patient diabetesobject object studi evalu efficaci nursemanag home telehealth intervent improv outcom veteran comorbid diabet htndesign singlecent random control clinic trial design compar two remot monitor intens level usual care patient type diabet htn treat primari care usedmeasur primari outcom hemoglobin ac systol blood pressur sbp secondari outcom adherenceresult intervent subject experienc decreas ac month intervent period compar control group month intervent withdrawn intervent group compar control group sbp highintens subject signific decreas sbp compar group month pattern maintain month adher improv time group differ among three groupslimit subject relat good baselin control ac sbp minor women underrepresentedconclus home telehealth provid innov pragmat approach enhanc earlier detect key clinic symptom requir intervent transmiss educ advic patient ongo basi close surveil nurs can improv clinic outcom patient comorbid chronic ill

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