T2D の遠隔医療を強化するパイロット研究

Specialty care for type 2 diabetes delivered via telemedicine by an endocrinologist, with additional multidisciplinary support from the diabetes care team.

Telemedicine-based endocrinology specialty care for type 2 diabetes with multidisciplinary diabetes care team support including pre-visit preparation, in-visit support and self-management education, and post-visit follow-up.

Specialty care for type 2 diabetes delivered via telemedicine by an endocrinologist following usual clinical care protocols.

Routine telemedicine-based endocrinology specialty care for type 2 diabetes, generally consisting of synchronous virtual visit with an endocrinologist and additional support including self-management education on an individualized basis.

Percent of eligible patients approached who are enrolled

Percent of enrolled patients who do not complete study, defined as not completing at least 2 study visits and associated surveys

Number of patients recruited per month

Percent of patients approached who are eligible

Percent of scheduled visits completed per patient

Number of successful and attempted patient contacts by clinicians between visits per patient

Number of telemedicine visits with blood glucose data available at visit per patient

Percent of patients reporting satisfied or very satisfied on a 5-point Likert scale ranging from 1 "strongly disagree" to 5 "strongly agree" with the statement "Overall, I am satisfied with the quality of service being provided via telemedicine" with higher scores indicating greater satisfaction

Total score of 8-item measure of global satisfaction with diabetes treatment regimen. The static version will be used at baseline. Items 1, 4, 5, 6, 7 & 8 are summed to produce a Treatment Satisfaction score (range:0 to 36). The higher the score, the greater the satisfaction with treatment. 'Perceived frequency of hyperglycaemia' (item 2) & 'Perceived frequency of hypoglycaemia' (item 3): Both rated: 6 ('most of the time') to 0 ('none of the time'). Here, lower scores indicate blood glucose levels closer to the ideal. Higher scores indicate problems.

Total score of 8-item measure of global satisfaction with diabetes treatment regimen. The change version will be used at 6 months.Items 1, 4, 5, 6, 7 and 8 are summed to produce a Treatment Satisfaction (change) score (range: +18 to -18). The higher the score, the greater the improvement in satisfaction with treatment; the lower the score, the greater the deterioration in satisfaction with treatment. A score of 0 represents no change. Two remaining items ('Perceived change in frequency of hyperglycaemia' (item 2) and 'Perceived change in frequency of hypoglycaemia' (item 3)) are treated individually: Both rated: +3 ('much more of the time now') to -3 ('much less of the time now').

Here, negative scores indicate fewer problems with blood glucose levels. Positive scores indicate more problems than before.

Change in total score of 8-item measure of diabetes-related distress over prior month from baseline to 6 months. The Diabetes Distress Core scale is scored by averaging the value for each item, ranked from 1 to 5 scale (score range 1-5), with higher scores indicating more distress.

Change in glycemic control from baseline to 6 months

Number of patients with indications for GLP-1 receptor agonist therapy who are prescribed the indicated medication

Number of patients with indications for SGLT2 inhibitor therapy who are prescribed the indicated medication

Number of patients with documentation of retinal examination performed in last year in medical record

Number of patients with documentation of urine protein testing performed in last year in medical record

Number of patients with documentation of pneumococcal vaccination in medical record

Number of patients with documentation of influenza vaccination in medical record