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      Long-term Effects of Remote Patient Monitoring in Patients Living with Diabetes: A Retrospective Look at Participants of the Mississippi Diabetes Telehealth Network Study

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          Abstract

          Introduction:

          Remote patient monitoring (RPM) has demonstrated value as a tool to aid patients in management of their chronic illness in the home. Although the Mississippi Diabetes Telehealth Network Study (MSDTNS) was successful in reducing HbgA1c levels for patients participating in RPM in the Mississippi Delta, the long-term effect of RPM on patients and how to support patients to maintain the treatment effect after discharge remain unclear.

          Objective:

          This study evaluated the long-term effectiveness of an RPM program after the intervention was withdrawn.

          Materials and Methods:

          A retrospective review of medical records of patients who completed all phases of the MSDTNS from 2014 to 2016 was performed over a period of 6 months. Data collected included HbgA1c values, demographics, and changes in social determinants of health.

          Results:

          Of the 31 participants, African Americans displayed a significant difference in HbgA1c values compared with Caucasians since the end of the MSDTNS. No significant effect of other variables, such as income, marital status, insurance coverage, or age, on the change in HbgA1c values was detected since the end of the original study.

          Conclusions and Relevance:

          This limited study implies that African Americans are at higher risk for an increase in hemoglobin A1C after the program is completed. More investigation is needed to identify ways to reduce their risk and equalize the long-term effects of RPM on clinical outcomes of patients in rural or underserved communities.

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          Remote patient monitoring: a comprehensive study

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            The impact of telehealth remote patient monitoring on glycemic control in type 2 diabetes: a systematic review and meta-analysis of systematic reviews of randomised controlled trials

            Background There is a growing body of evidence to support the use of telehealth in monitoring HbA1c levels in people living with type 2 diabetes. However, the overall magnitude of effect is yet unclear due to variable results reported in existing systematic reviews. The objective of this study is to conduct a systematic review and meta-analysis of systematic reviews of randomised controlled trials to create an evidence-base for the effectiveness of telehealth interventions on glycemic control in adults with type 2 diabetes. Methods Electronic databases including The Cochrane Library, MEDLINE, EMBASE, HMIC, and PsychINFO were searched to identify relevant systematic reviews published between 1990 and April 2016, supplemented by references search from the relevant reviews. Two independent reviewers selected and reviewed the eligible studies. Of the 3279 references retrieved, 4 systematic reviews reporting in total 29 unique studies relevant to our review were included. Both conventional pairwise meta-analyses and network meta-analyses were performed. Results Evidence from pooling four systematic reviews found that telehealth interventions produced a small but significant improvement in HbA1c levels compared with usual care (MD: -0.55, 95% CI: -0.73 to − 0.36). The greatest effect was seen in telephone-delivered interventions, followed by Internet blood glucose monitoring system interventions and lastly interventions involving automatic transmission of SMBG using a mobile phone or a telehealth unit. Conclusion Current evidence suggests that telehealth is effective in controlling HbA1c levels in people living with type 2 diabetes. However there is need for better quality primary studies as well as systematic reviews of RCTs in order to confidently conclude on the impact of telehealth on glycemic control in type 2 diabetes. Electronic supplementary material The online version of this article (10.1186/s12913-018-3274-8) contains supplementary material, which is available to authorized users.
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              Multiple imputation for nonresponse in surveys

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                Author and article information

                Journal
                Telemed Rep
                Telemed Rep
                tmr
                Telemedicine Reports
                Mary Ann Liebert, Inc., publishers (140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA )
                2692-4366
                June 2022
                2022
                June 2022
                : 3
                : 1
                : 130-136
                Affiliations
                [ 1 ]University of Mississippi Medical, Center for Telehealth, Jackson, Mississippi, USA.
                [ 2 ]Department of Data Science, University of Mississippi Medical Center, John D. Bower School of Population Health, Jackson, Mississippi, USA.
                Author notes

                Information in this report has been presented at SEARCH 2021—The National Telehealth Research Symposium November 8–10, 2021, Virtual Meeting. https://doi.org/10.1089/tmj.2022.29069.abstracts

                [*] [ * ]Address correspondence to: Tearsanee Carlisle Davis, DNP, APRN, FNP-BC, FAANP, University of Mississippi Medical, Center for Telehealth, 2500 N. State Street, Jackson, MS 39216, USA. tcdavis2@ 123456umc.edu
                Author information
                https://orcid.org/0000-0002-5274-8788
                Article
                10.1089/tmr.2022.0009
                10.1089/tmr.2022.0009
                9282779
                35860303
                23148cb1-c4d7-47f6-a296-e24eeed28e6d
                © Tearsanee Carlisle Davis et al., 2022; Published by Mary Ann Liebert, Inc.

                This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : Accepted March 24, 2022
                Page count
                Figures: 1, Tables: 2, References: 13, Pages: 7
                Categories
                Original Research

                access,diabetes,remote patient monitoring,rural health,telehealth

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