Web-based collaborative care for type 2 diabetes: a pilot randomized trial.

Center for Health Studies, Group Health Cooperative, Seattle, Washington, USA.
Diabetes care (Impact Factor: 8.57). 11/2008; 32(2):234-9. DOI: 10.2337/dc08-1220
Source: PubMed

ABSTRACT To test Web-based care management of glycemic control using a shared electronic medical record with patients who have type 2 diabetes.
We conducted a trial of 83 adults with type 2 diabetes randomized to receive usual care plus Web-based care management or usual care alone between August 2002 and May 2004. All patients had GHb > or =7.0%, had Web access from home, and could use a computer with English language-based programs. Intervention patients received 12 months of Web-based care management. The Web-based program included patient access to electronic medical records, secure e-mail with providers, feedback on blood glucose readings, an educational Web site, and an interactive online diary for entering information about exercise, diet, and medication. The primary outcome was change in GHb.
GHb levels declined by 0.7% (95% CI 0.2-1.3) on average among intervention patients compared with usual-care patients. Systolic blood pressure, diastolic blood pressure, total cholesterol levels, and use of in-person health care services did not differ between the two groups.
Care management delivered through secure patient Web communications improved glycemic control in type 2 diabetes.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: With significant declines in cardiovascular disease (CVD) mortality, attention has shifted to patient management. Programs designed to manage CVD require the involvement of health professionals for comanagement and patients' self-management. However, these programs are commonly limited to large urban centers, resulting in limited access for rural patients. The use of telehealth potentially overcomes geographical barriers and can improve access to care for patients. The current research explores how an Internet-based platform might facilitate collaboration among healthcare providers comanaging patients and enhance behavioural change in patients. Forty-eight participants were interviewed including: (a) patients (n = 12), (b) physicians (n = 11), (c) nurses (n = 13), and (d) allied health professionals (n = 10). The results were organized and analyzed in three central themes: (1) role of technology for CVD management, (2) challenges to technology adoption, and (3) incentives for technology adoption. Health care providers and patients supported future implementation of Internet-based technology support for CVD management.
    International Journal of Telemedicine and Applications 07/2011; 2011:342582. DOI:10.1155/2011/342582
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We assessed the feasibility and acceptability of using mobile phones as part of an existing Web-based system for collaboration between patients with diabetes and a primary care team. In design sessions, we tested mobile wireless glucose meter uploads and two approaches to mobile phone-based feedback on glycemic control. Mobile glucose meter uploads combined with graphical and tabular data feedback were the most desirable system features tested. Participants had a mixture of positive and negative reactions to an automated and tailored messaging feedback system for self-management support. Participants saw value in the mobile system as an adjunct to the Web-based program and traditional office-based care. Mobile diabetes management systems may represent one strategy to improve the quality of diabetes care.
    Journal of Biomedical Informatics 10/2010; 43(5 Suppl):S37-40. DOI:10.1016/j.jbi.2010.05.004 · 2.48 Impact Factor
  • Source
    Patient Education and Counseling 11/2009; 77(1):1-3. DOI:10.1016/j.pec.2009.08.006 · 2.60 Impact Factor


Available from