QUEBEC CITY — Canadian researchers think they've found a way to improve diabetes management by using a Web-based, real-time tracking system linked to patients' electronic medical records.
The Computerization of Medical Practices for the Enhancement of Therapeutic Effectiveness study's COMPETE II diabetes tracker is available to both patients and physicians and electronically displays 13 standardized variables, including blood glucose, hemoglobin A1c levels, blood pressure, blood lipid levels, urinary albumin-creatinine ratios, and the most recent foot and eye exams, Lisa Dolovich, Pharm.D., explained at the annual meeting of the North American Primary Care Research Group.
Dr. Dolovich presented data from the COMPETE II study, in which 511 patients with type 2 diabetes under the care of 48 primary care physicians were randomized to the tracker or to usual care.
The study's primary outcome was the change from baseline to 6 months in the quality of monitoring 8 of the 13 variables, compared with targets for each patient. A composite score was assigned each patient, with a maximum of 11 points. At a mean follow-up of 8.5 months, the mean composite score significantly improved in the intervention group, compared with the control group (change of 2.35 vs. 0.80).
Compared with the control group, diastolic blood pressure was reduced by 2.62 mm Hg, systolic blood pressure by 4.09 mm Hg, and hemoglobin A1c by 0.2% in the intervention group.
Despite being repeatedly nudged by telephone reminders, 192 (76%) of 253 intervention patients said they were as satisfied or more satisfied with their care as a result of the intervention, and 63% opted to continue receiving automated reminders.