Limitations
In this small-scale pilot study, we provided a telehealthcare program that consisted of 3G glucometers, free test strips, an online diabetes self-management system, and easy access to professional support. All the program components contributed to patient improvements, although we did not measure the individual contribution of each of the components. Unfortunately, the contribution of each of the components remains unclear; this is a limitation of this study. However, those with T1DM received free test strips from the NHI. The program did produce a small benefit of HbA1c control for the T1DM patients (HbA1c decreased from 7.83 to 7.74), implying that the free glucometer strips were not solely responsible for the outcomes of this program.
The mean HbA1c value for the telehealthcare group during the last period dropped to 7.68 and was still considered not well controlled. This may be because of the enrollment of patients with very poor glycemic control. In addition, the therapeutic responses may require more time since HbA1c is a measure of average blood glucose over the course of 3 months. The patient education in this study was based on the observations of different CDEs (3 nurses and 2 dietitians), and the evaluation result may differ from CDE to CDE. Another limitation was that before the development of the DMIS, the documentation of patient education was paper-based rather than structured in the AADE7 form. The DMIS went online in July 2011 and stabilized in August 2011; the telehealthcare program was initiated in September 2011. Hence, we were unable to obtain patients’ documentation before their entry into the telehealthcare program.
Limitations
In this small-scale pilot study, we provided a telehealthcare program that consisted of 3G glucometers, free test strips, an online diabetes self-management system, and easy access to professional support. All the program components contributed to patient improvements, although we did not measure the individual contribution of each of the components. Unfortunately, the contribution of each of the components remains unclear; this is a limitation of this study. However, those with T1DM received free test strips from the NHI. The program did produce a small benefit of HbA1c control for the T1DM patients (HbA1c decreased from 7.83 to 7.74), implying that the free glucometer strips were not solely responsible for the outcomes of this program.
The mean HbA1c value for the telehealthcare group during the last period dropped to 7.68 and was still considered not well controlled. This may be because of the enrollment of patients with very poor glycemic control. In addition, the therapeutic responses may require more time since HbA1c is a measure of average blood glucose over the course of 3 months. The patient education in this study was based on the observations of different CDEs (3 nurses and 2 dietitians), and the evaluation result may differ from CDE to CDE. Another limitation was that before the development of the DMIS, the documentation of patient education was paper-based rather than structured in the AADE7 form. The DMIS went online in July 2011 and stabilized in August 2011; the telehealthcare program was initiated in September 2011. Hence, we were unable to obtain patients’ documentation before their entry into the telehealthcare program.
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