Abstract
Aim
Healthcare professionals are leveraging on telehealth to manage patients with type-2 diabetes mellitus (T2DM). This study aimed to determine the clinical outcomes of patients using a novel tele-monitoring system (OPTIMUM) as compared to the standard of care.
Methods
An open-labelled randomised controlled trial involving 330 Asian patients with T2DM, aged 26–65 years, and suboptimal glycaemic control (HbA1c = 7.5–10%) was conducted in a Singapore public primary care clinic. The patients were assigned in a 1:1 ratio by block randomization to the intervention group to receive: in-app video-based tele-education, tele-monitoring of the blood pressure (BP), capillary glucose and weight via Bluetooth devices and mobile application, followed by algorithm-based tele-management by the OPTIMUM telehealth care team for abnormal parameters. Patients received usual care in the control group. Clinical assessments and self-care-related questionnaires were administered for both groups at baseline and 6 months.
Results
Complete data of 159 (intervention) and 160 (control) patients with comparable demographic profiles were analysed. Those in the intervention group showed significantly lower HbA1c by 0.34% (95%CI = −0.57 to −0.11; p = 0.004); first measurement of systolic BP decreased by 2.98 mmHg (95%CI:−5.8 to −0.08; p = 0.044) and diastolic BP by 4.24 mmHg (95%CI = −6.0 to −2.47; p = 0.001); and total cholesterol by 0.18 mmol/L (95%CI: −0.34 to −0.01; p = 0.040) compared to the control group, after adjusting for baseline variables. Questionnaire scores showed significant improvements in medication adherence and self-care behaviour in the intervention group. No significant weight change was noted between groups.
Conclusion
The OPTIMUM tele-monitoring system improved the glycaemic, BP and total cholesterol control in patients with suboptimal T2DM control by enhancing their medication adherence and self-care over 6 months.
Keywords
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