None listed
Conditions
Brief summary
This randomised controlled trial will explore whether remote access to clinical care, supported by telehealth technologies over high speed broadband, leads to improved diabetes control in a way that benefits patients, carers and clinicians, and improves the overall health system. People with poorly controlled type 2 diabetes mellitus who reside in the suburbs connected to the national broadband network will be recruited from general practices (GP). People in the intervention arm of the trial will receive additional diabetes care from a diabetes educator nurse via an in-home broadband communication device that can capture clinical measures, provide regular health assessments and videoconference with other health professionals when required. The GPs will continue to manage their patients’ care in partnership with the diabetes educator nurse (DEN). The intervention period is 12 months. Each care plan will include frequency for remote monitoring of clinical measures and patient health assessments, and protocols for managing changes in the clinical status of the patient. The DEN will be in close communication with the GPs throughout the trial. Patients in the control arm of the trial will receive usual care from their GP and participate in the clinical measurement and quality of life components of the evaluation. On completion of the trial, the control patients will be offered remote DEN care for a three month period. The trial evaluation will include biomedical, psychological, self management and quality of life measures. Data on utilisation rates and satisfaction with the technology will be collected, and cost -effectiveness analyses undertaken. The role of this technology on health care reform will be explored. The trial aims to answer the following specific questions about remote telehealth monitoring: Does it improve health outcomes? Does it improve the experience of care for patients , their carers and clinicians? Does it improve primary care capacity and integration of care? Does it improve service utilisation and efficiency of the healthcare workforce? How well does it utilize the high speed broadband network?
Interventions
The intervention is 12 months in duration. Using NBN telehealth technologies patients will receive online diabetes care from a doiabetes educator nurse (DEN) via an in-home broadband monitoring and communication device that can prompt the capture of clinical measures including: regular blood pressure monitoring (at least once a week depending on patient); regular blood glucose monitoring (at least once a week depending on patient) ; 6 monthly participation in monitored online health questionnai
The intervention is 12 months in duration. Using NBN telehealth technologies patients will receive online diabetes care from a doiabetes educator nurse (DEN) via an in-home broadband monitoring and communication device that can prompt the capture of clinical measures including: regular blood pressure monitoring (at least once a week depending on patient); regular blood glucose monitoring (at least once a week depending on patient) ; 6 monthly participation in monitored online health questionnaires to reinforce diabetes self management and assist early detection of complications; participation in clinical video conferencing sessions as required with diabetes educator nurse and GP (on a case by case basis).
Sponsors
Townsville Mackay Medicare Local (TMML)
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
For a patient to be included in the trial: Have a regular GP providing primary care The practice should have a diabetes register (using Canning data extractor tool or equivalent) Patients should: Be diagnosed with type 2 Diabetes (not type 1) Live in a National Broadband Network (NBN) connected area in their home (not a residential aged care facility) & be willing to connect to NBN at no cost Be an adult, aged 18 years or over Have recorded a HbA1c greater than or equal to 7.5 % at any time in the previous 12 months (or if no result available, HbA1c greater than or equal to 7.5 % when tested)
Exclusion criteria
Patients should be excluded if they have any of the following conditions or characteristics: Pregnancy Cancer (except non-melanotic skin cancer) diagnosed in the previous 12 months Palliative care Intellectual and mental impairment (that would preclude use of technology) Dementia (that would preclude use of technology) Primary language other than English Chronic kidney disease and on dialysis or likely to be on dialysis within the timeframe of the trial Severe vision impairment (if deemed unable to use technology) Severe unstable co-morbidities as assessed by GP as unlikely to survive for the 12 month period of the trial Current enrolment in another health intervention trial
Outcome results
None listed