[ADA2014]社区远程医疗系统有助于改善中国2型糖尿病管理_远程医疗_社区_2型糖尿病_糖尿病管理_ADA2014

[ADA2014]社区远程医疗系统有助于改善中国2型糖尿病管理

2014-06-19 来源：医脉通

关键词：远程医疗社区 2型糖尿病糖尿病管理 ADA2014

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由北京安贞医院内分泌代谢科陶红主任医师负责完成一项研究显示，新型交互式实时家庭远程医疗系统有助于改善中国社区糖尿病">2型糖尿病患者的HbA1c控制和生活质量。该研究摘要6月15日在第74届美国糖尿病协会科学年会（ADA2014）上发布。

2型糖尿病显然已成为中国目前一个重要的公共卫生问题。无法实现患者的规律和自我管理，就无法有效控制糖尿病；采用远程技术对改善糖尿病治疗和预后具有潜力。

在本次研究中，我们尝试了一种新型交互式实时家庭远程医疗系统，目标是控制患者与生活方式相关的危险因素，并逐步实施行为改变干预措施。本研究的目的是探讨该系统是否有助于改善糖尿病患者的代谢控制以及生活质量。

我们在北京某社区卫生服务中心进行了这项随机对照试验，共纳入120名2型糖尿病患者。患者被随机分配至常规治疗组或远程治疗组，随访6个月。远程治疗组的患者接受家庭远程医疗单元（HTU）治疗。通过网站，病例管理护士可提供病人的个体化管理项目，包括重要因素监测、行为监测、糖尿病并发症监测、糖尿病教育、饮食和运动管理。患者通过HTU接收任务并反馈数据。病例管理护士接收数据或根据数据提供反馈。

经过6个月的干预，远程组患者HbA1c的降幅大于常规治疗组（P<0.05）。此外，远程治疗组的生活质量总评分（P=0.01）、疾病（P<0.05）、心理（P<0.05）、社会角色（P<0.05）、满意度（P<0.05）显著优于常规治疗组，而生理角色则没有区别。

我们的研究结果表明，与常规护理相比，短期的远程医疗干预，包括护士提供以指南为基础、患者为中心的糖尿病管理可显著改善2型糖尿病患者的HbA1c控制和生活质量。

【研究摘要】

Abstract Number:	2442-PO
Title:	An Interactive Telemedicine System Improves Diabetes Management for Type 2 Diabetic Patients in China（交互式远程医疗系统改善中国2型糖尿病患者的糖尿病管理）
Authors:	HONG TAO, XIU QIN SUN, JIAN HUA HE, XIAN XIAN YUAN, ZHEN RU HUANG, Beijing, China
Abstract:	It is obviously that T2DM is a major public health issue for China now. With the inability to achieve control of diabetes through routine provider visits and patient self-management, interventions that use tele technology have the potential to improve outcomes of diabetes care. So we try a new type of interactive real time home telecare system, with the goal of controlling multiple risk factors associated with lifestyle and a stepwise implementation of behavior modification. The aim of the study is to investigate whether it can help improve patient’s diabetes metabolic control,as well as the quality of life. We conducted a randomized, controlled trial in a community health service center in Beijing, involving 120 participants with type 2 diabetes. Patients were randomly assigned to the usual-care group or to the tele care group and followed for 6 months.Participants in the telecare group received a home telemedicine unit (HTU) . Through the website the nurse case manager provides patient’s individualized manager project including important factors monitoring, behavior monitoring, diabetes complication monitoring, diabetes education, food and activation management. The patients receive the mission and feedback their data through the HTU. The nurse case manager relieves message or callbacks according to the data. After 6 months intervention, patients in the telecare group had greater reduction of HbA1c (P<0.05) as compared with usual care group. Furthermore, telecare group was superior to usual care with respects to QOL(quality of life) total score(P=0.01), disease(P<0.05), psychological (P<0.05), role social (P<0.05), and satisfaction(P<0.05), whereas no difference in role Physiological. Our results showed that as compared with usual care, a short- term telemedicine intervention involving nurses who provided guideline-based, patient-centered management of diabetes significantly improved HbA1c control and the quality of life.