Life-long Tele-monitoring of Patients With Type 2 Diabetes Mellitus in Central Greece (RHCluster2GR)

Study Description

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

To evaluate whether patients with type 2 diabetes mellitus can be followed by simplified, centralized and large scale tele-monitoring of blood glucose levels and blood pressure, and whether this intervention produces health and economic benefits when introduced without major changes to the existing organization of a large tertiary care center.

Condition or disease	Intervention/treatment	Phase
Diabetes Mellitus, Type 2	Procedure: Telemonitoring of patients with diabetes type 2	Not Applicable

Detailed Description:

The present study aims to examine the clinical and financial effects and the patients' perception and satisfaction of home telemedicine support system for diabetes management versus standard (usual) care. In the intervention group the patients will be provided with a blood glucose meter and a mobile phone and their data will be transferred via the mobile to the regional database and will be assessed by the allocated care team. Appropriate counseling on treatment and symptoms or problems related to diabetes will also be provided.

Measurements of HbA1c will be taken to assess glycaemic control while the dietary and the exercise habits will be assessed by the use of questionnaires. In addition the patients' satisfaction from the use of the telemedicine service will be studied. A Cost-Effective Analysis and Cost Utility Analysis will be applied to evaluate the tele-health service compared with the usual care from the health and social perspective. The effect of the tele-health service in the organization structure of the outpatient hospital department will be evaluated with a qualitative study.

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	154 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Single (Outcomes Assessor)
Primary Purpose:	Supportive Care
Official Title:	Renewing Health RCT for the Evaluation of Life-long Tele-monitoring of Patients With Diabetes Mellitus Type 2 in Central Greece
Study Start Date :	March 2011
Actual Primary Completion Date :	December 2013
Actual Study Completion Date :	January 2014

Arms and Interventions

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Arm	Intervention/treatment
No Intervention: Usual care; Participants in the control group receive usual care. Usual care consists of regular visits to the specialist when required. In the occasion of the visit, HbA1c and glucose measurements are performed and the current oral or insulin therapy is modified if necessary. Patients also receive basic education in the management of diabetes.
Experimental: Telemonitoring of diabetes 2 patients; Patients will have one educational visit to set up the system and explain how it works. Patients will download their measurements from their tele-glucose meter to their mobile phone and the data will be transferred to the regional database. The care team (a nurse specially trained and the allocated physician) will regularly access the patient's home diary, and will provide the appropriate counselling and medication changes as frequently as necessary. In addition to blood glucose measurements, routine questions about symptoms and eventual difficulties related to diabetes as well as diabetic management will be routinely captured and reported.	Procedure: Telemonitoring of patients with diabetes type 2; Telemonitoring of the patients's blood glucose level measurements using a the tele-glucose meter

Outcome Measures

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Primary Outcome Measures :

1. Health related quality of life of the patients measured by the SF-36 version 2 questionnaire [ Time Frame: 12 months minimum- at the entry point of the intervention and the end. ]
2. HbA1c levels [ Time Frame: 12 months minimum - at the entry point and every 3 months. ]
   Glycated hemoglobin (HbA1c) levels at the entry point and every 3 months (for a period of 12 months minimum)

Secondary Outcome Measures :

1. Emotional functioning in diabetes assessed by the "Problem areas in diabetes questionnaire - PAID © 1999 Joslin Diabetes Center" [ Time Frame: 12 months minimum- at the entry point of the intervention and the end. ]
2. Physical activity measured by the "International Physical Activity Questionnaire" (IPAQ) [ Time Frame: 12 months minimum- at the entry point of the intervention and the end. ]
3. Nutrition habits assessed by validated questionnaire. [ Time Frame: 12 months minimum- at the entry point of the intervention and the end. ]
4. Patients' Acceptance-Satisfaction measured by the WSD Questionnaire [ Time Frame: at 2nd and at 12th month ]
5. Economic Evaluation (Cost-Effective Analysis- Cost Utility Analysis) [ Time Frame: 12 months minimum ]

Eligibility Criteria

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Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• Diagnosis of type 2 Diabetes
• HbA1c > 53 mmol/mol (7.0 % according to NGSP)
• Capability to use the devices provided
• Being cognitively able to participate
• Capability of filling in questionnaires in german or greek language
• Absence of severe comorbidity prevalent on diabetes with life expectancy < 12 months

Exclusion Criteria:

• Pregnancy

Contacts and Locations

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

Greece
Endocrinology and Metabolic Diseases Department - Regional University Hospital of Larisa
Larisa, Thessaly, Greece, 41110

Sponsors and Collaborators

Regional Health Authority of Sterea & Thessaly

Ministry for Health and Social Solidarity, Greece

Municipality of Trikala, Greece

e-Trikala S.A.

Cities Net SA

Institute of Biomedical Research & Technology, Larissa, Greece

Institute of Communications and Computer Systems, Athens, Greece

Alexander Technological Educational Institute, Thessaloniki, Greece

University of Macedonia, Thessaloniki, Greece

University of Thessaly

Investigators

Principal Investigator:	Georgios Koukoulis, MD, PhD	Endocrinology and Metabolic Diseases Department - Regional University Hospital of Larisa

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Additional Information:

&quot;The Renewing Health project is partially funded under the ICT Policy Support Programme (ICT PSP) as part of the Competitiveness and Innovation Framework Programme by the European Community&quot; 

Publications:

Polisena J, Tran K, Cimon K, Hutton B, McGill S, Palmer K. Home telehealth for diabetes management: a systematic review and meta-analysis. Diabetes Obes Metab. 2009 Oct;11(10):913-30. doi: 10.1111/j.1463-1326.2009.01057.x. Epub 2009 Jun 16. Review.

Klonoff DC. Diabetes and telemedicine: is the technology sound, effective, cost-effective, and practical? Diabetes Care. 2003 May;26(5):1626-8. Review.

Jaana M, Paré G. Home telemonitoring of patients with diabetes: a systematic assessment of observed effects. J Eval Clin Pract. 2007 Apr;13(2):242-53. Review.

Responsible Party:	Georgios Koukoulis, Associate Proffesor, Director of the Endocrinology and Metabolic Diseases Department, University Hospital of Larissa, Regional Health Authority of Sterea & Thessaly
ClinicalTrials.gov Identifier:	NCT01498367 History of Changes
Other Study ID Numbers:	FR2015; EC Grant Agreement 250487 ( Other Grant/Funding Number: European Commission CIP/PSP-ICT Grant Agreement 250487 )
First Posted:	December 23, 2011
Last Update Posted:	February 18, 2015
Last Verified:	February 2015

Keywords provided by Georgios Koukoulis, Regional Health Authority of Sterea & Thessaly:

Diabetes Mellitus, Type 2; Telemedicine

Additional relevant MeSH terms:

Diabetes Mellitus; Diabetes Mellitus, Type 2; Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases