Keywords: telemedicine, family medicine, chronic diseases, feasibility, acceptability
Background:
With the increasing availability and rapid development of information and communication technologies, especially the Internet, the use of telemedicine is also becoming more widespread. The aim of telemedicine is to improve the quality of patient's care.
Research questions:
In the pilot project of managing patients with diabetes and arterial hypertension in Slovenia tested the feasibility and acceptability of telemedicine monitoring for patients and health care workers, the impact on the health related outcomes and the workload of health care workers.
Method:
We included 100 patients with arterial hypertension, arterial hypertension and diabetes or diabetes only who were able to use blood pressure and /or blood glucose monitors and a smartphone, based on a pragmatic approach to sampling. Patients were monitored for 6 months in accordance with a pre-designed protocol that followed national guidelines. According to the protocol, patients transmitted the blood pressure and sugar values to a nurse, who provided additional instructions or referred the patient to a doctor. Qualitative data analyses of semi structured interviews with patients and health care workers were made.
Results:
The method was feasible and acceptable for patients with basic e-literacy. It means some additional workload for the nurse, but the workload of a doctor or emergency department has not increased. The method contributed positively to the patient's knowledge of the disease and treatment; brought additional information about the values of blood pressure and blood glucose profile and helped the physician in adaptation of treatment.
Conclusions:
A pilot project confirmed that telemedicine monitoring is feasible and acceptable for patients with basic e-literacy; however, due to the methods used and short follow-up time and, we were unable to assess the impact of the cost and health related outcomes.
Points for discussion:
Experiences with telemedicine in the management of patients with chronic diseases other countries?
Which outcomes are the most relevant in assessment of the usefulness of telemedicine in primary care?
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