Web-based Collaborative Care for Type 2 Diabetes: a Pilot Randomized Trial
- James D. Ralston, MD, MPH (ralston.j{at}ghc.org)(1),
- Irl B. Hirsch, MD(2),
- James Hoath, PhD(3),
- Mary Mullen, BA(4),
- Cheadle Allen, PhD(5) and
- Harold I. Goldberg, MD(4)
- 1. Group Health Cooperative, Center for Health Studies
- 2. University of Washington Department of Medicine, Division of Endocrinology, Metabolism and Nutrition
- 3. University of Washington Medical Center Information Services
- 4. University of Washington Department of Medicine, Division of General Internal Medicine
- 5. University of Washington School of Public Health and Community Medicine
Abstract
Objective: To test Web-based care management of glycemic control using a shared electronic medical record with patients who have type 2 diabetes.
Research Design and Methods: A trial of 83 adults with type 2 diabetes randomized to receive usual care plus Web-based care management or usual care alone between August 2002 and May 2004. All patients had a glycohemoglobin (GHb) ≥7.0%, Web access from home, and could use a computer in English.
Research Design and Methods: Intervention patients received 12 months of Web-based care management. The Web-based program included patient access to electronic medical records, secure e-mail with providers, feedback on blood glucose readings, an educational Web site, and an interactive online diary for entering exercise, diet, and medication. Primary outcome was change in GHb.
Results: GHb levels declined by 0.7% (95% CI: 0.2 –1.3) on average among intervention patients compared to usual care patients. Systolic blood pressure, diastolic blood pressure, total cholesterol levels Use of in-person health care services did not differ between the two groups.
Conclusions: Care management delivered through secure patient Web communications improved glycemic control in type 2 diabetes.
Footnotes
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- Received July 7, 2008.
- Accepted November 7, 2008.
- Copyright © American Diabetes Association
