Web-Based Care Management in Patients With Poorly Controlled Diabetes

@article{citeulike:1769677, abstract = {OBJECTIVE--To assess the effects of web-based care management on glucose and blood pressure control over 12 months in patients with poorly controlled diabetes. RESEARCH DESIGN AND METHODS--For this study, 104 patients with diabetes and HbA1c (A1C) [\&ge;]9.0\% who received their care at a Department of Veterans Affairs medical center were recruited. All participants completed a diabetes education class and were randomized to continue with their usual care (n = 52) or receive web-based care management (n = 52). The web-based group received a notebook computer, glucose and blood pressure monitoring devices, and access to a care management website. The website provided educational modules, accepted uploads from monitoring devices, and had an internal messaging system for patients to communicate with the care manager. RESULTS--Participants receiving web-based care management had lower A1C over 12 months (P < 0.05) when compared with education and usual care. Persistent website users had greater improvement in A1C when compared with intermittent users (-1.9 vs. -1.2\%; P = 0.051) or education and usual care (-1.4\%; P < 0.05). A larger number of website data uploads was associated with a larger decline in A1C (highest tertile -2.1\%, lowest tertile -1.0\%; P < 0.02). Hypertensive participants in the web-based group had a greater reduction in systolic blood pressure (P < 0.01). HDL cholesterol rose and triglycerides fell in the web-based group (P < 0.05). CONCLUSIONS--Web-based care management may be a useful adjunct in the care of patients with poorly controlled diabetes. 10.2337/diacare.28.7.1624}, author = {Mcmahon, Graham T. and Gomes, Helen E. and Hickson and Hu, Tang M. and Levine, Betty A. and Conlin, Paul R. }, citeulike-article-id = {1769677}, doi = {http://dx.doi.org/10.2337/diacare.28.7.1624}, journal = {Diabetes Care}, keywords = {2, bioinformatics, care, diabetes, endocrinology, healthcare, informatics, internet, medical, medicine, mellitus, online, self-care, telemedicine, treatment, type, web-based, webmed, webmedicine}, month = {July}, number = {7}, pages = {1624--1629}, posted-at = {2007-10-15 11:22:31}, priority = {0}, title = {Web-Based Care Management in Patients With Poorly Controlled Diabetes}, url = {http://dx.doi.org/10.2337/diacare.28.7.1624}, volume = {28}, year = {2005} }

TY - JOUR ID - citeulike:1769677 L3 - citeulike-article-id:1769677 TI - Web-Based Care Management in Patients With Poorly Controlled Diabetes JF - Diabetes Care VL - 28 IS - 7 SP - 1624 EP - 1629 N2 - OBJECTIVE--To assess the effects of web-based care management on glucose and blood pressure control over 12 months in patients with poorly controlled diabetes. RESEARCH DESIGN AND METHODS--For this study, 104 patients with diabetes and HbA1c (A1C) [&ge;]9.0% who received their care at a Department of Veterans Affairs medical center were recruited. All participants completed a diabetes education class and were randomized to continue with their usual care (n = 52) or receive web-based care management (n = 52). The web-based group received a notebook computer, glucose and blood pressure monitoring devices, and access to a care management website. The website provided educational modules, accepted uploads from monitoring devices, and had an internal messaging system for patients to communicate with the care manager. RESULTS--Participants receiving web-based care management had lower A1C over 12 months (P < 0.05) when compared with education and usual care. Persistent website users had greater improvement in A1C when compared with intermittent users (-1.9 vs. -1.2%; P = 0.051) or education and usual care (-1.4%; P < 0.05). A larger number of website data uploads was associated with a larger decline in A1C (highest tertile -2.1%, lowest tertile -1.0%; P < 0.02). Hypertensive participants in the web-based group had a greater reduction in systolic blood pressure (P < 0.01). HDL cholesterol rose and triglycerides fell in the web-based group (P < 0.05). CONCLUSIONS--Web-based care management may be a useful adjunct in the care of patients with poorly controlled diabetes. 10.2337/diacare.28.7.1624 KW - 2 KW - bioinformatics KW - care KW - diabetes KW - endocrinology KW - healthcare KW - informatics KW - internet KW - medical KW - medicine KW - mellitus KW - online KW - self-care KW - telemedicine KW - treatment KW - type KW - web-based KW - webmed KW - webmedicine AU - Mcmahon, Graham AU - Gomes, Helen AU - Hickson AU - Hu, Tang AU - Levine, Betty AU - Conlin, Paul PY - 2005/07/01/ UR - http://dx.doi.org/10.2337/diacare.28.7.1624 ER -