基于手机的远程医疗实践在老年 2 型糖尿病患者中的应用：随机对照试验。
Mobile Phone-Based Telemedicine Practice in Older Chinese Patients with Type 2 Diabetes Mellitus: Randomized Controlled Trial.
机构信息
Department of Endocrinology, First Hospital of Jilin University, Changchun, China.
Health Management Center, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
出版信息
JMIR Mhealth Uhealth. 2019 Jan 4;7(1):e10664. doi: 10.2196/10664.
BACKGROUND
Previous studies on telemedicine interventions have shown that older diabetic patients experience difficulty in using computers, which is a barrier to remote communication between medical teams and older diabetic patients. However, older people in China tend to find it easy to use mobile phones and personal messaging apps that have a user-friendly interface. Therefore, we designed a mobile health (mHealth) system for older people with diabetes that is based on mobile phones, has a streamlined operation interface, and incorporates maximum automation.
OBJECTIVE
The goal of the research was to investigate the use of mobile phone-based telemedicine apps for management of older Chinese patients with type 2 diabetes mellitus (T2DM). Variables of interest included efficacy and safety.
METHODS
A total of 91 older (aged over 65 years) patients with T2DM who presented to our department were randomly assigned to one of two groups. Patients in the intervention group (n=44) were provided glucometers capable of data transmission and received advice pertaining to medication, diet, and exercise via the mHealth telemedicine system. Patients assigned to the control group (n=47) received routine outpatient care with no additional intervention. Patients in both groups were followed up at regular 3-month intervals.
RESULTS
After 3 months, patients in the intervention group showed significant (P<.05) improvement in postprandial plasma glucose level. After 6 months, patients in the intervention group exhibited a decreasing trend in postprandial plasma glucose and glycated hemoglobin levels compared with the baseline and those in the control group (P<.05).
CONCLUSIONS
Mobile phone-based telemedicine apps help improve glycemic control in older Chinese patients with T2DM.
TRIAL REGISTRATION
China Clinical Trial Registration Center ChiCTR 1800015214; http://www.chictr.org.cn/showprojen.aspx?proj=25949 (Archived by WebCite at http://www.webcitation.org/73wKj1GMq).
背景
以往关于远程医疗干预的研究表明，老年糖尿病患者在使用计算机方面存在困难，这是医疗团队与老年糖尿病患者进行远程沟通的障碍。然而，中国的老年人往往觉得使用界面友好的手机和个人通讯应用程序很容易。因此，我们为老年糖尿病患者设计了一个基于手机的移动医疗（mHealth）系统，该系统操作界面精简，并尽可能实现自动化。
目的
本研究旨在探讨基于手机的远程医疗应用程序在管理中国老年 2 型糖尿病（T2DM）患者中的应用。关注的变量包括疗效和安全性。
方法
共纳入 91 名 65 岁以上的 T2DM 患者，随机分为两组。干预组（n=44）患者配备可传输数据的血糖仪，并通过 mHealth 远程医疗系统获得有关药物、饮食和运动的建议。对照组（n=47）患者接受常规门诊护理，无其他干预措施。两组患者均每 3 个月定期随访。
结果
3 个月后，干预组患者餐后血糖水平显著改善（P<.05）。6 个月后，与基线相比，干预组患者的餐后血糖和糖化血红蛋白水平呈下降趋势，且低于对照组（P<.05）。
结论
基于手机的远程医疗应用程序有助于改善中国老年 T2DM 患者的血糖控制。
试验注册
中国临床试验注册中心 ChiCTR1800015214；http://www.chictr.org.cn/showprojen.aspx?proj=25949（由 WebCite 存档，http://www.webcitation.org/73wKj1GMq）。
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