title: The Utah Remote Monitoring Project: improving health care one patient at a time.
abstract: BACKGROUND
  The expanding role of technology to augment diabetes care and management highlights the need for clinicians to learn about these new tools. As these tools continue to evolve and enhance improved outcomes, it is imperative that clinicians consider the role of telemonitoring, or remote monitoring, in patient care. This article describes a successful telemonitoring project in Utah.
  
  
  METHODS
  This was a nonrandomized prospective observational preintervention-postintervention study, using a convenience sample. Patients with uncontrolled diabetes and/or hypertension from four rural and two urban primary care clinics and one urban stroke center participated in a telemonitoring program. The primary clinical outcome measures were changes in hemoglobin A1C (A1C) and blood pressure. Other outcomes included fasting lipids, weight, patient engagement, diabetes knowledge, hypertension knowledge, medication adherence, and patient perceptions of the usefulness of the telemonitoring program.
  
  
  RESULTS
  Mean A1C decreased from 9.73% at baseline to 7.81% at the end of the program (P<0.0001). Systolic blood pressure also declined significantly, from 130.7 mm Hg at baseline to 122.9 mm Hg at the end (P=0.0001). Low-density lipoprotein content decreased significantly, from 103.9 mg/dL at baseline to 93.7 mg/dL at the end (P=0.0263). Other clinical parameters improved nonsignificantly. Knowledge of diabetes and hypertension increased significantly (P<0.001 for both). Patient engagement and medication adherence also improved, but not significantly. Per questionnaires at study end, patients felt the telemonitoring program was useful.
  
  
  CONCLUSIONS
  Telemonitoring improved clinical outcomes and may be a useful tool to help enhance disease management and care of patients with diabetes and/or hypertension.
authors.affiliation: 1 Department of Pharmacotherapy, University of Utah College of Pharmacy , Salt Lake City, Utah.
authors.forename: Laura
authors.initials: L
authors.lastname: Shane-McWhorter
authors.forename: Leslie
authors.initials: L
authors.lastname: Lenert
authors.forename: Marta
authors.initials: M
authors.lastname: Petersen
authors.forename: Sarah
authors.initials: S
authors.lastname: Woolsey
authors.forename: Carrie
authors.initials: C
authors.lastname: McAdam-Marx
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Coursey
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Whittaker
authors.forename: Christian
authors.initials: C
authors.lastname: Hyer
authors.forename: Deb
authors.initials: D
authors.lastname: LaMarche
authors.forename: Patricia
authors.initials: P
authors.lastname: Carroll
authors.forename: Libbey
authors.initials: L
authors.lastname: Chuy
mesh_terms: D001794:Blood Pressure; D001795:Blood Pressure Determination; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D058996:Quality Improvement; D011787:Quality of Health Care / Q000458:organization & administration / Q000592:standards; D012424:Rural Population; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data; D017216:Telemedicine / Q000458:organization & administration / Q000592:standards; D014505:Urban Population; D014589:Utah / Q000453:epidemiology; D016903:Drug Monitoring
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008077:Lipoproteins, LDL; C517652:hemoglobin A1c protein, human