title: Effect of home telemonitoring on glycemic and blood pressure control in primary care clinic patients with diabetes.
abstract: OBJECTIVE
  Patient self-management support may be augmented by using home-based technologies that generate data points that providers can potentially use to make more timely changes in the patients' care. The purpose of this study was to evaluate the effectiveness of short-term targeted use of remote data transmission on treatment outcomes in patients with diabetes who had either out-of-range hemoglobin A1c (A1c) and/or blood pressure (BP) measurements.
  
  
  METHODS
  A single-center randomized controlled clinical trial design compared in-home monitoring (n=55) and usual care (n=53) in patients with type 2 diabetes and hypertension being treated in primary care clinics. Primary outcomes were A1c and systolic BP after a 12-week intervention.
  
  
  RESULTS
  There were no significant differences between the intervention and control groups on either A1c or systolic BP following the intervention.
  
  
  CONCLUSIONS
  The addition of technology alone is unlikely to lead to improvements in outcomes. Practices need to be selective in their use of telemonitoring with patients, limiting it to patients who have motivation or a significant change in care, such as starting insulin. Attention to the need for effective and responsive clinic processes to optimize the use of the additional data is also important when implementing these types of technology.
authors.affiliation: 1 Iowa City Veterans Administration Medical Center , Iowa City, Iowa.
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Wakefield
authors.forename: Richelle J
authors.initials: RJ
authors.lastname: Koopman
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Keplinger
authors.forename: Marilee
authors.initials: M
authors.lastname: Bomar
authors.forename: Beth
authors.initials: B
authors.lastname: Bernt
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Johanning
authors.forename: Robin L
authors.initials: RL
authors.lastname: Kruse
authors.forename: J Wade
authors.initials: JW
authors.lastname: Davis
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Wakefield
authors.forename: David R
authors.initials: DR
authors.lastname: Mehr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D011320:Primary Health Care; D012648:Self Care / Q000379:methods; D017216:Telemedicine
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human