Use of a Telehomecare Program for Young Patients With New Onset Type 1 Diabetes

NCT ID: NCT01401790

Last Updated: 2011-07-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

86 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-02-29

Study Completion Date

2009-08-31

Brief Summary

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In a Pediatric University Teaching Hospital in Montreal, an Intelligent Distance Patient Monitoring Program was developed to allow for:

* Automatic download of blood glucose levels
* Automatic alerts indicating hypoglycemias, hyperglycemias and ketones to the medical team
* Changes in treatment plan by the diabetes professionals
* E mail exchanges between families and health care professionals
* Reinforcement of teaching program

Use of this program does not replace the existing diabetes education program nor does it preclude contacts with the diabetes team. This service was devised to complement the care already in place for families of children and adolescents with diabetes, hence the term ''telehomecare-enhanced'' approach.

Hypotheses

* This approach would not incur more health problems for Web e Phone users when compared to patients treated by the ''conventional'' approach (telephone and FAX).
* Use of the Web e Phone would save time for members of the diabetes health providers and consequently cut costs.
* This means of communication would be acceptable and user friendly for both families and health care professionals.

OBJECTIVE - To determine the effects of a telehomecare (THC) program used for 3 months in families of children and adolescents with newly diagnosed type 1 diabetes.

RESEARCH DESIGN AND METHODS - A bilingual telehomecare program was developed for type 1 diabetes at the Centre Hospitalier Universitaire Sainte-Justine in Montreal. Between February 2008 and August 2009, newly diagnosed patients and their family were randomly assigned to the standard education program or to the telehomecare-enhanced group. Outcomes of interest were patients' and parents' health (reported number for total and nocturnal hypoglycemias; quality of life using the Diabetes Quality of life for Youth questionnaire and a validated Life Habits survey); knowledge of diabetes (using pre and post intervention questionnaires); organizational impacts (number and time for contacts with the nurses or with the physician on call) and family satisfaction with the software application.

Detailed Description

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STUDY PROTOCOL

This is a randomized controlled study, unblinded.

The recruitment occured on Day 3 of teaching: random assignment (1:1) to receive either traditional follow up (telephone contacts and FAX communications) with the designated nurse OR a follow up with telehomecare PLUS the follow up by a specialized nurse.

If the patient is designated to telehomecare, the training is provided on day of recruitment and patient leaves with the Web e Phone. Activation of the device must be done at home to enable for transmission of information.

Families complete questionnaires to evaluate knowledge, Quality of Life Questionnaires (Skinner modified), a validated Life Habits survey and a satisfaction questionnaire at recruitment (time 0) and at study completion (3 months) (Children must be aged more than 8 years).

All reported hypoglycemias (less than 3 mmol/L) and nocturnal hypoglycemias by any means (telephone, FAX or Web e Phone) during the follow up period (suggested for 3 months) are to be accounted for.

Conditions

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Diabetes Mellitus, Type 1

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Telehomecare

3 month use of a new telehomecare program

Group Type EXPERIMENTAL

Telehomecare (Intelligent Distance Patient Monitoring)

Intervention Type DEVICE

Randomized patients were to be taugth and to use for 3 months a telehomecare program designed for

* Automatic download of blood glucose levels
* Automatic alerts indicating hypoglycemias, hyperglycemias and ketones to the medical team
* Changes in treatment plan by the diabetes professionals
* E mail exchanges between families and health care professionals
* Reinforcement of teaching program

Control

3 month regular education program and follow up at the Diabetes Clinic

Group Type ACTIVE_COMPARATOR

Standard education and follow up at diabetes clinic

Intervention Type OTHER

Patients allocated to the control branch receive standard diabetes teaching and care.

Interventions

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Telehomecare (Intelligent Distance Patient Monitoring)

Randomized patients were to be taugth and to use for 3 months a telehomecare program designed for

* Automatic download of blood glucose levels
* Automatic alerts indicating hypoglycemias, hyperglycemias and ketones to the medical team
* Changes in treatment plan by the diabetes professionals
* E mail exchanges between families and health care professionals
* Reinforcement of teaching program

Intervention Type DEVICE

Standard education and follow up at diabetes clinic

Patients allocated to the control branch receive standard diabetes teaching and care.

Intervention Type OTHER

Other Intervention Names

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Telehealth Telemonitoring Standard diabetes care

Eligibility Criteria

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Inclusion Criteria

* Child or adolescent with newly diagnosed type 1 diabetes

Exclusion Criteria

* Inability to write or communicate in writing in French or English Blindness Exclusive follow up in another health center once teaching is complete
Minimum Eligible Age

6 Months

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Huot, Celine, M.D.

OTHER

Sponsor Role lead

Responsible Party

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Centre Hospitalier Universitaire Sainte-Justine

Locations

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Centre Hospitalier Universitaire Sainte-Justine

Montreal, Quebec, Canada

Site Status

Countries

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Canada

References

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Chase HP, Pearson JA, Wightman C, Roberts MD, Oderberg AD, Garg SK. Modem transmission of glucose values reduces the costs and need for clinic visits. Diabetes Care. 2003 May;26(5):1475-9. doi: 10.2337/diacare.26.5.1475.

Reference Type BACKGROUND
PMID: 12716807 (View on PubMed)

d'Annunzio G, Bellazzi R, Larizza C, Montani S, Pennati C, Castelnovi C, Stefanelli M, Rondini G, Lorini R. Telemedicine in the management of young patients with type 1 diabetes mellitus: a follow-up study. Acta Biomed. 2003;74 Suppl 1:49-55.

Reference Type BACKGROUND
PMID: 12817805 (View on PubMed)

Izquierdo R, Morin PC, Bratt K, Moreau Z, Meyer S, Ploutz-Snyder R, Wade M, Weinstock RS. School-centered telemedicine for children with type 1 diabetes mellitus. J Pediatr. 2009 Sep;155(3):374-9. doi: 10.1016/j.jpeds.2009.03.014. Epub 2009 May 21.

Reference Type BACKGROUND
PMID: 19464030 (View on PubMed)

Pare G, Jaana M, Sicotte C. Systematic review of home telemonitoring for chronic diseases: the evidence base. J Am Med Inform Assoc. 2007 May-Jun;14(3):269-77. doi: 10.1197/jamia.M2270. Epub 2007 Feb 28.

Reference Type BACKGROUND
PMID: 17329725 (View on PubMed)

Rami B, Popow C, Horn W, Waldhoer T, Schober E. Telemedical support to improve glycemic control in adolescents with type 1 diabetes mellitus. Eur J Pediatr. 2006 Oct;165(10):701-5. doi: 10.1007/s00431-006-0156-6. Epub 2006 May 3.

Reference Type BACKGROUND
PMID: 16670859 (View on PubMed)

Skinner TC, Hoey H, McGee HM, Skovlund SE; Hvidore Study Group on Childhood Diabetes. A short form of the Diabetes Quality of Life for Youth questionnaire: exploratory and confirmatory analysis in a sample of 2,077 young people with type 1 diabetes mellitus. Diabetologia. 2006 Apr;49(4):621-8. doi: 10.1007/s00125-005-0124-0. Epub 2006 Jan 26.

Reference Type BACKGROUND
PMID: 16525844 (View on PubMed)

Related Links

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http://www.chu-sainte-justine.org/Pro/Page.aspx?ID_PAGE=10002900

Description of technological evaluation ongoing in institution where the project is done

Other Identifiers

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CHUSTEJUSTINE2644

Identifier Type: -

Identifier Source: org_study_id

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