Telemedicine helps diabetics achieve good glycemic control
MedWire News: Results from the Pro-Active Call Centre Treatment Support (PACCTS) trial suggest that a telemedicine intervention can help diabetes patients achieve good glycemic control without additional pharmacotherapy.
Ram Narayanan (University of Manchester, UK) and colleagues describe 3-year results from the study demonstrating that the telemedicine intervention reduced glycated hemoglobin (HbA1c) by 0.24% more than usual care alone.
Initially, 591 patients were recruited to take part in the trial, two-thirds of whom were randomly assigned to have proactive telecare support from specially trained telehealthcare advisors, and a third to receive usual care. After 1-year, 501 patients continued to a 2-year extension phase. By 3 years, a further 76 patients had discontinued the intervention.
The telehealthcare advisors provided telephone advice on lifestyle and medication after being trained by a specialist diabetes nurse for 3 months.
Narayanan and team report that, in addition to the improvement in mean HbA1c levels seen in the intervention compared with the usual-care group, significantly more telehealthcare-supported patients achieved the target HbA1c of 7% compared with usual-care patients, at 29.8% versus 20.3%.
Use of diabetes medications in the two groups over the 3-year period was also compared and found to be similar, suggesting that patients in the intervention group did not simply benefit from taking additional medications.
"We therefore report that proactive telecare support in addition to usual care demonstrates a continued beneficial effect on glucose control at 3 years," write Narayanan et al in the journal Diabetic Medicine.
"We believe this is clinically relevant, and is likely to be through improved medication compliance and lifestyle measures in the intervention arm, rather than differences in pharmacological interventions between the groups."
The team concludes: "Our work adds more evidence to the application of telemedicine in the management of diabetes and other chronic illnesses."
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By Helen Albert