MedWire News: Home telehealth is clinically effective for patients with diabetes, resulting in better glycemic control and reduced hospitalizations, show results from a systematic review.
Home telehealth is an effective alternative for some aspects of traditional care in the management of chronic diseases and includes home telemonitoring and telephone support.
Home telemonitoring involves data transmission and audio or video monitoring. Telephone support is patient or caregiver support, which includes advice, education, and follow-up by a health-care provider, usually through telephone contact. It does not involve electronic transmission of patient outcome data.
To assess the potential benefits of home telehealth compared with usual care for patients with diabetes, Julia Polisena (Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario, Canada) and co-workers performed a systematic review and meta-analysis of the literature on home telehealth for patients with diabetes published between 1998 and 2008.
They identified 26 studies of over 5000 patients. Of the 21 studies that evaluated home telemonitoring, 12 were randomized controlled trials and nine were observational studies. All five telephone support studies were randomized controlled trials.
The results, reported in the journal Diabetes, Obesity and Metabolism, reveal that overall, home telemonitoring has a positive effect on glycemic control with pooled results from the 12 randomized controlled trials demonstrating significantly lower glycated hemoglobin (HbA1c) levels compared with usual care.
The results for telephone support were mixed, with two trials reporting a lower HbA1c compared with usual care and two trials reporting a higher HbA1c level in patients using telephone support.
The authors also report that home telehealth helps to reduce the number of patients hospitalized, frequency of hospitalizations and bed days of care. The evidence on the use of health services for telephone support was limited because studies that compared telephone support with usual care focused mainly on clinical outcomes such as HbA1c.
The authors acknowledge great variability in the quality of studies reviewed and say that the results should therefore be interpreted with caution.
However, Polisena et al conclude: “In general, home telehealth had a positive impact on the use of numerous health services and glycemic control. More studies of higher methodological quality are required to give more precise insights into the potential clinical effectiveness of home telehealth interventions.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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