@Article{信息:doi 10.2196 / / jmir.9.5。e37，作者="Verhoeven, Fenne and van Gemert-Pijnen, Lisette and Dijkstra, Karin and Nijland, Nicol and Seydel, Erwin and stehouder, Micha{\"e}l"，标题="远程会诊和视频会议对糖尿病护理的贡献:一项系统文献综述"，期刊="J Med Internet Res"，年="2007"，月=" 12 "，日="14"，卷="9"，数="5"，页数="e37"，关键词="慢性疾病;糖尿病;远程医疗;咨询;远程咨询;背景:本研究对远程会诊和视频会议在糖尿病多方面护理过程中的益处进行了系统的文献综述。以前的评论主要关注技术的可用性，考虑的主要是片面的干预。目的:目的是确定远程会诊和视频会议在糖尿病护理的临床、行为和护理协调结果方面的优点和不足。方法:检索相关出版物的电子数据库(Medline、PiCarta、psyinfo、ScienceDirect、Telemedicine Information Exchange、ISI Web of Science、谷歌Scholar)。 The contribution to diabetes care was examined for clinical outcomes (eg, HbA1c, blood pressure, quality of life), behavioral outcomes (patient-caregiver interaction, self-care), and care coordination outcomes (usability of technology, cost-effectiveness, transparency of guidelines, equity of care access). Randomized controlled trials (RCTs) with HbA1c as an outcome were pooled using standard meta-analytical methods. Results: Of 852 publications identified, 39 met the inclusion criteria for electronic communication between (groups of) caregivers and patients with type 1, type 2, or gestational diabetes. Studies that evaluated teleconsultation or videoconferencing not particularly aimed at diabetes were excluded, as were those that described interventions aimed solely at clinical improvements (eg, HbA1c). There were 22 interventions related to teleconsultation, 13 to videoconferencing, and 4 to combined teleconsultation and videoconferencing. The heterogeneous nature of the identified videoconferencing studies did not permit a formal meta-analysis. Pooled results from the six RCTs of the identified teleconsultation studies did not show a significant reduction in HbA1c (0.03{\%}, 95{\%} CI = - 0.31{\%} to 0.24{\%}) compared to usual care. There was no significant statistical heterogeneity among the pooled RCTs ($\chi$27= 7.99, P = .33). It can be concluded that in the period under review (1994-2006) 39 studies had a scope broader than clinical outcomes and involved interventions allowing patient-caregiver interaction. Most of the reported improvements concerned satisfaction with technology (26/39 studies), improved metabolic control (21/39), and cost reductions (16/39). Improvements in quality of life (6/39 studies), transparency (5/39), and better access to care (4/39) were hardly observed. Teleconsultation programs involving daily monitoring of clinical data, education, and personal feedback proved to be most successful in realizing behavioral change and reducing costs. The benefits of videoconferencing were mainly related to its effects on socioeconomic factors such as education and cost reduction, but also on monitoring disease. Additionally, videoconferencing seemed to maintain quality of care while producing cost savings. Conclusions: The selected studies suggest that both teleconsultation and videoconferencing are practical, cost-effective, and reliable ways of delivering a worthwhile health care service to diabetics. However, the diversity in study design and reported findings makes a strong conclusion premature. To further the contribution of technology to diabetes care, interactive systems should be developed that integrate monitoring and personalized feedback functions. ", issn="1438-8871", doi="10.2196/jmir.9.5.e37", url="//www.mybigtv.com/2007/5/e37/", url="https://doi.org/10.2196/jmir.9.5.e37", url="http://www.ncbi.nlm.nih.gov/pubmed/18093904" }