Mortality risk for diabetes patients in a care coordination, home-telehealth programme.
We assessed a home monitoring/care coordination programme for veterans with diabetes. Patients enrolled in the programme (n = 387) were followed for four years and compared with a retrospective control group (n = 387). Each patient in the intervention group used a messaging device in the home that was connected by a conventional telephone line. Care coordinators monitored the answers from the devices daily so that early interventions could be made. There were significantly more deaths in the control group (n = 102, 26%) compared with the intervention group (n = 75, 19%). There was longer survival for the intervention group versus the control group (mean survival time 1348 vs 1278 days; P = 0.015). A multivariate analyses indicated that the telemonitoring programme was associated with reduced 4-year all-cause mortality (hazard ratio = 0.7, 95% CI 0.5-0.9, P = 0.013). The results suggest that daily management of patients with diabetes through home monitoring by a registered nurse reduces mortality.
Chumbler
Neale R
NR
VA HSR&D Center on Implementing Evidence-Based Practice, Roudebush VAMC, 1481 West Tenth Street, Indianapolis, IN 46202, USA. nchumble@iupui.edu
Chuang
Ho-Chih
HC
Wu
Samuel S
SS
Wang
Xinping
X
Kobb
Rita
R
Haggstrom
David
D
Jia
Huanguang
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000401:mortality* / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D012044:Regression Analysis; D012307:Risk Factors; D015996:Survival Rate; D017216:Telemedicine / Q000295:instrumentation* / Q000592:standards; D014728:Veterans; D055815:Young Adult