Patients with diabetes who use telemedicine modalities to connect with their health care providers may have improved blood glucose levels, study data show.
“Our findings suggest that text messaging and web portals may be especially effective mechanisms for linking providers to patients with diabetes,” the researchers wrote. “The use of [Short Message Service] text messaging may be feasible to communicate and motivate patients, which could result in positive outcomes.”
Marcello Tonelli, MD, SM, of the department of medicine at the University of Calgary in Canada, and colleagues conducted a systematic review on 11 randomized controlled trials to determine the effect of telemedicine compared with usual care on HbA1c and health-related quality of life in people with diabetes.
Communication with health care providers was conducted by voice, text messaging and transmission of data, and health care providers communicated with patients by voice, text messaging, images and through clinical decision-support systems.
Telemedicine was effective in reducing HbA1c at less than 3 months (difference in means, –0.57%), 4 to 12 months (difference in means, –0.28%) and more than 12 months (difference in means, –0.26%).
Overall, 23 studies used instruments reporting on quality of life, and the instruments included were Diabetes Quality of Life, Diabetes Distress Scale, the European Quality of Life Survey with Five Dimensions, the Problem Areas in Diabetes, Hypoglycemia (patient-years) and Hypoglycemia (percent of patients affected). Among the studies, there was significant improvement in the Problem Areas in Diabetes score with telemedicine (difference in means at 4-12 months, 2.86); however, there was significant worsening in physical function, social functioning and the European Quality of Life Survey with Five Dimensions.
No evidence was found suggesting telemedicine reduces the risks for hypoglycemic episodes or severe hypoglycemic episodes.
“Our systematic review showed that telemedicine may be a useful supplement to usual clinical care to control HbA1c, at least in the short term,” the researchers wrote. “Telemedicine interventions appeared to be most effective when they use a more interactive format, such as a web portal or text messaging, to help patients with self-management.” – by Amber Cox
Disclosure: Tonelli reports no relevant financial disclosures. Please see the full study for list of all other authors’ relevant financial disclosures.