A Comparison of Low- and High-Intensity Monitoring in Veterans with Co-Morbid Diabetes and Hypertension

2.50
Hdl Handle:
http://hdl.handle.net/10755/160847
Type:
Presentation
Title:
A Comparison of Low- and High-Intensity Monitoring in Veterans with Co-Morbid Diabetes and Hypertension
Abstract:
A Comparison of Low- and High-Intensity Monitoring in Veterans with Co-Morbid Diabetes and Hypertension
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2009
Author:Wakefield, Bonnie, PhD
P.I. Institution Name:Harry S Truman Memorial Veterans Hospital
Contact Address:Research Service, 800 Hospital Drive, Columbia, MO, 65201, USA
Contact Telephone:5738146548
Co-Authors:B.J. Wakefield, Harry S. Truman Memorial Veterans Hospital, Columbia, MO; J.E. Holman, A. Ray, M. Scherubel, M. Simons, S. Hillis, G.E. Rosenthal, Center for Implementation of Innovative Strategies in Practice (CRIISP), Iowa City VA Medical Center, Iowa C
This study evaluated the efficacy of remote monitoring with nurse care management (NCM) in improving outcomes in veterans with co-morbid diabetes and hypertension. 302 subjects were randomized to three groups: low-intensity monitoring plus NCM (n=102); high-intensity monitoring plus NCM (n=93); and usual care (n=107). Intervention patients transmitted vital signs daily. The low intensity group answered two general health questions; the high intensity group responded to a complete range of questions on diabetes and hypertension, and received educational tips. The intervention lasted for 6 months. Most subjects were male (98%) Caucasians (96%) with a mean age of 68 years (range 40-89 years). The three groups were comparable at baseline for mean HbA1c (7.1, 7.1, 7.2) and systolic blood pressure (134, 139, 134) for control, high, and low intensity respectively). At 6 months the control group mean HbA1c was unchanged but the high- and low-intensity groups had dropped significantly (to 6.7 and 6.8 respectively) (F=4.24, p=0.02). For systolic BP there was a significant time by group interaction, i.e., control and low-intensity subjects had small changes, but the high-intensity subjects dropped by 7 points (F=6.01, p=0.003). Medication adherence (Morisky) improved significantly over time for all three groups (F=3.91, p=0.05), but there were no differences among the groups. Results indicate that the intervention was most effective in improving combined outcomes in the high intensity group. Although remote monitoring offers a number of theoretical advantages, most projects have focused on single disease populations, e.g., heart failure. Furthermore, few controlled clinical trials have investigated varying the intervention dose. Since remote monitoring may hold the most promise for individuals with multiple chronic illnesses, these results are promising and provide data to design tailored remote monitoring interventions for primary care patients.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Comparison of Low- and High-Intensity Monitoring in Veterans with Co-Morbid Diabetes and Hypertensionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160847-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Comparison of Low- and High-Intensity Monitoring in Veterans with Co-Morbid Diabetes and Hypertension</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Wakefield, Bonnie, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Harry S Truman Memorial Veterans Hospital</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Research Service, 800 Hospital Drive, Columbia, MO, 65201, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">5738146548</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">bonnie.wakefield@va.gov</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">B.J. Wakefield, Harry S. Truman Memorial Veterans Hospital, Columbia, MO; J.E. Holman, A. Ray, M. Scherubel, M. Simons, S. Hillis, G.E. Rosenthal, Center for Implementation of Innovative Strategies in Practice (CRIISP), Iowa City VA Medical Center, Iowa C</td></tr><tr><td colspan="2" class="item-abstract">This study evaluated the efficacy of remote monitoring with nurse care management (NCM) in improving outcomes in veterans with co-morbid diabetes and hypertension. 302 subjects were randomized to three groups: low-intensity monitoring plus NCM (n=102); high-intensity monitoring plus NCM (n=93); and usual care (n=107). Intervention patients transmitted vital signs daily. The low intensity group answered two general health questions; the high intensity group responded to a complete range of questions on diabetes and hypertension, and received educational tips. The intervention lasted for 6 months. Most subjects were male (98%) Caucasians (96%) with a mean age of 68 years (range 40-89 years). The three groups were comparable at baseline for mean HbA1c (7.1, 7.1, 7.2) and systolic blood pressure (134, 139, 134) for control, high, and low intensity respectively). At 6 months the control group mean HbA1c was unchanged but the high- and low-intensity groups had dropped significantly (to 6.7 and 6.8 respectively) (F=4.24, p=0.02). For systolic BP there was a significant time by group interaction, i.e., control and low-intensity subjects had small changes, but the high-intensity subjects dropped by 7 points (F=6.01, p=0.003). Medication adherence (Morisky) improved significantly over time for all three groups (F=3.91, p=0.05), but there were no differences among the groups. Results indicate that the intervention was most effective in improving combined outcomes in the high intensity group. Although remote monitoring offers a number of theoretical advantages, most projects have focused on single disease populations, e.g., heart failure. Furthermore, few controlled clinical trials have investigated varying the intervention dose. Since remote monitoring may hold the most promise for individuals with multiple chronic illnesses, these results are promising and provide data to design tailored remote monitoring interventions for primary care patients.</td></tr></table>en_GB
dc.date.available2011-10-26T23:11:39Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:11:39Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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