Telemedicine in a randomized trial in type 2 diabetes

What is it about?

New approaches on outpatient control are required and need testing to motivate and give feedback to the patients at home. Telemedicine has the capacity to achieve this, optimizing care through motivation and direct feedback adapted to milieu of the patient and at the same time to keep the total cost at a reasonable level. We evaluated the economic and short time health effect of two different ways of outpatient treatment in patients with type 2 diabetes (T2DM). A health economist calculated the total cost of replacing the standard care with telemedicine.

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Why is it important?

Whether the focus is on telemedicine, medical informatics, IT-based education or telemedicine treatment of complications, the majority of experimental studies concludes that technological interventions are feasible and accepted by patients and clinical staff (2,8). Despite any technical problems, patients are happy for the technology (7). The only exception to this is in the field of decision support systems. A few randomized trials are available evaluating the immediate health effects with this technology in quantitative terms and our aim was to implement a telemedicine and replace the standard treatment in our setting. The trial evaluated the quality of treatment as well as technical issues. We performed a randomized trial and compared clinical data from a telemedicine group with a standard care group treated by the same medical algorithm. We added a health economist to our group to calculate on the total cost by replacing one way of care with another. We wanted to reduce the barriers for the use of a home monitoring and -treatment among elderly, T2DM patients. Our hypothesis was that treatment results in similar HbA1c, lipids, blood pressure and clinical variables by telemedicine or standard care in T2DM patients.