Type 2 Diabetes: Key Messages
- Home telehealth can be highly beneficial for people with type 2 diabetes. There is strong evidence that it can reduce HbA1c, lower blood pressure, improve exercise habits, and raise self-efficacy and quality of life. Under some circumstances, it can also improve cholesterol, body mass index, and diet. Improvements are often greater than those seen with usual care.
- Patient satisfaction is generally high, but technical problems and demanding data entry requirements have a negative effect on uptake. Limited interest in long-term participation suggests that brief, high-intensity interventions that target specific patient subgroups may be the most effective way to use home telehealth for type 2 diabetes.
- Little is known about patient time and cost savings.
- Nurses take on a large amount of the workload with home telehealth programs. They are usually the patient’s first point of contact and often take on the role of care coordinator.
- Home telehealth was integrated into type 2 diabetes care to an extent seen in few other chronic diseases. Program delivery often involved multi-disciplinary teams headed by nurses who acted as care coordinators. Those considering implementing home telehealth will find numerous examples of large-scale implementations in the literature.
- There are clear indications that providers will resist using technology if it is cumbersome to operate or difficult to incorporate into existing workflow. This can have negative effects on patient care. However, high levels of provider satisfaction have been achieved in some studies.
- Economic analyses show mixed results. Most take place in the United States and are of limited applicability to the Canadian health care system. Targeting select patient subgroups may improve the cost-effectiveness of home telehealth programs.
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