Outcomes of a Home Telehealth Intervention for Patients with Diabetes and Hypertension
Telemedicine and e-Health. October 2012, 18(8): 575-579. doi:10.1089/tmj.2011.0237. Bonnie J. Wakefield, John E. Holman, Annette Ray, Melody Scherubel, Margaret R. Adams, Stephen L. Hills, and Gary E. Rosenthal 1Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa. 2Iowa City Veterans Affairs Healthcare System, Iowa City, Iowa.
Background: Home telehealth programs often focus on a single disease, yet many patients who need monitoring have multiple conditions. This study evaluated secondary outcomes from a clinical trial evaluating the efficacy of home telehealth to improve outcomes of patients with co-morbid diabetes and hypertension.
Subjects and Methods: A single-center randomized controlled clinical trial compared two remote monitoring intensity levels (low and high) and usual care in patients with type 2 diabetes and hypertension being treated in primary care. Secondary outcomes assessed were knowledge (diabetes, hypertension, medications), self-efficacy, adherence (diabetes, medications), and patient perceptions of the intervention mode.
Results: Knowledge scores improved in the high-intensity intervention group participants, but upon further analysis, we found the intervention effect was not mediated by gain in knowledge. No significant differences were found across the groups in self-efficacy, adherence, or patient perceptions of the intervention mode.
Conclusions: Home telehealth can enhance detection of key clinical symptoms that occur between regular physician visits. While our intervention improved glycemic and blood pressure control, the mechanism of the effect for this improvement was not clear.