Telemedicine as a tool for intensive management of diabetes:: the DIABTel experience

被引:104
作者
Gómez, EJ
Hernando, ME
García, A
Del Pozo, F
Cermeño, J
Corcoy, R
Brugués, E
De Leiva, A
机构
[1] Univ Politecn Madrid, ETSI Telecommun, Grp Bioingn & Telemed, E-28040 Madrid, Spain
[2] Hosp St Pau Barcelona, Serv Endocrinol & Nutr, Barcelona, Spain
关键词
telemedicine; diabetes care; clinical evaluation; patient supervised autonomy;
D O I
10.1016/S0169-2607(02)00039-1
中图分类号
TP39 [计算机的应用];
学科分类号
081203 ; 0835 ;
摘要
This paper presents the, current features of the DIABTel telemedicine system and the evaluation outcomes of its use in clinical routine. This telemedicine system is designed to complement the daily care and intensive management of diabetic patients through telemonitoring and telecare services. The system comprises a patient unit (PU) used by patients in their day-to-day activities and a Medical Workstation used by physicians and nurses at hospitals. Both applications offer tools to collect, manage, view and interpret data and to exchange data and messages. The system was evaluated for usability, telemedical protocols, metabolic control and quality of life. This evaluation consisted in a 6-month cross-over pilot study with ten Type I diabetic patients. The results of the evaluation allowed assessment of the telemedicine protocols in terms of the number of communications/patient (21.6 +/- 7.7); days between communications (5.4 +/- 2.66); messages sent by physicians (118 text messages); and data and messages transmitted by patients (3524 blood glucose readings, 1649 day-to-day insulin adjustments, 24 exercise reports, ten diet modifications and 63 text messages). Physicians performed more therapeutic changes during the DIABTel period than in the control period. There was a trend towards HbAlc improvement during DIABTel use with no incidence in the number of hypoglycaemias. This pilot study demonstrates the feasibility of the DIABTel system in clinical routine use and its potential benefits for diabetes care: improving the availability of information necessary for therapy adjustments; offering new physician-patient communication tools; increasing patient empowerment and education; and showing a positive trend towards improving the metabolic control of patients. Further studies are needed to validate these findings and to promote telemedicine as an opportunity to better diabetes care. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:163 / 177
页数:15
相关论文
共 29 条
[1]  
ABRAMS L, 2000, TELEMED TODAY, V16
[2]   TELEPHONE MODEM ACCESS IMPROVES DIABETES CONTROL IN THOSE WITH INSULIN-REQUIRING DIABETES [J].
AHRING, KK ;
AHRING, JPK ;
JOYCE, C ;
FARID, NR .
DIABETES CARE, 1992, 15 (08) :971-975
[3]   Diabetes intervention in the information age [J].
Albisser, AM ;
Harris, RI ;
Sakkal, S ;
Parson, ID ;
Chao, SCE .
MEDICAL INFORMATICS, 1996, 21 (04) :297-316
[4]  
[Anonymous], 1999, DIABETES CARE S1, DOI DOI 10.2337/diacare.22.1.1
[5]  
Bell HK, 1998, LEARN PUBL, V11, P67
[6]   TELEMATIC TRANSMISSION OF COMPUTERIZED BLOOD-GLUCOSE PROFILES FOR IDDM PATIENTS [J].
BILLIARD, A ;
ROHMER, V ;
ROQUES, MA ;
JOSEPH, MG ;
SURANITI, S ;
GIRAUD, P ;
LIMAL, JM ;
FRESSINAUD, P ;
MARRE, M .
DIABETES CARE, 1991, 14 (02) :130-134
[7]   Computers in diabetes - an introduction [J].
Carson, ER ;
Andreassen, S ;
Cavan, DA ;
Gomez, EJ .
COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE, 2000, 62 (03) :153-155
[8]  
CERMENO J, 2000, DIAB RES CLIN PRAC, V50, pP811
[9]  
deLeiva A, 1996, DIABETOLOGIA, V39, P5
[10]  
DELPOZO F, 1991, DIABETES NUTR MET S1, V4, P149